Nurse Education Today 35 (2015) 251–255

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Career interest, self-efficacy, and perception in undecided and nursing undergraduate students: A quantitative study Valentina M. Fillman ⁎ Saint Francis Medical Center College of Nursing, 511 NE Greenleaf, Peoria, IL 61603, United States

a r t i c l e

i n f o

Article history: Accepted 25 August 2014 Keywords: Career choice Nursing Students Recruitment

s u m m a r y Career choice variables of career interest, self-efficacy, and perception were chosen based upon Social Cognitive Career Theory concepts for study between nursing and undecided undergraduate student groups. Components of the Career Search Questionnaire and Perceptions of Professional Nursing instruments were combined and adapted to form the Career Choice Survey for use in this research. This web-based survey totaling 40 questions was sent to 577 undergraduate students with a 12% response rate (N = 68). Due to the need to increase nursing recruitment and retention, hypotheses were developed that distinguish if any relationship existed between groups. Findings of this quantitative study resulted in statistically significant results on two of the three variable hypotheses (p = .006 for career interest, p = .002 for self-efficacy, p = .395 for perception), aligning with previous research and provide insight into the change in nursing perception. Overall, scores for each subscale were encouraging to current nurses and expected from undecided students. Implications for practice include increases in accurate nursing portrayal in the media and early career counseling to younger populations. Nurse educators can further research in career choice with focus on continuing education for current nurses and recruitment of young nursing hopefuls. © 2014 Elsevier Ltd. All rights reserved.

The shortage of nurses has become such an issue that it brings multiple disciplines together to research, report, and support efforts to recruit and educate future generations of this profession (American Association of Colleges of Nursing (AACN), 2013). The U.S. Bureau of Labor Statistics (2012b) projects a registered nurse growth of 26% from 2010 to 2020, a need for over 700,000 new graduates in this decade, with a higher demand for a baccalaureate entrance degree and graduate certifications. The increase in healthcare coverage legislation and aging population coupled with the aging workforce forecasts this increasing demand (AACN, 2013). Entering the field as a nurse is not the only challenge in the nursing profession: with the current faculty shortages reported, almost two-thirds of baccalaureate and graduate student applicants are turned away unable to advance their education (AACN, 2013). Encouraging nursing as a career choice to students of all ages can prevent career disillusionment, nursing school dropout, and stimulate interest to the profession (Buerhaus et al., 2000; Turner, 2011). By identifying students at earlier ages who wish to enter the field of nursing, the profession will benefit from confident and valuable individuals capable of lessening the nursing shortage. Examining relationships between undecided students and nursing undergraduate students, specifically examining their career interest, self-efficacy, and perceptions, can add to the body of knowledge surrounding career choice and influencing ⁎ Tel.: +1 309 655 6352; fax: +1 309 624 8973. E-mail address: valentina.m.fi[email protected].

http://dx.doi.org/10.1016/j.nedt.2014.08.011 0260-6917/© 2014 Elsevier Ltd. All rights reserved.

nursing education to pursue the recruitment and retention of future nurses. Nurse educators and scholars have a key role in impacting the perception of the nursing field through professionalism and dedication to improvement through continued diligence in research efforts. Background The U. S. Department of Labor reported in 2012 that registered nurses were at the very top of the list of careers with the largest projected growth from 2010 to 2020. Reasons for this projection come from an aging nursing workforce, an aging population, healthcare reform, and an anticipated boost in the economy will make a renewed critical nursing need (American Nurses Association, 2013). Research suggests that the nursing shortage will continue unless efforts are made to increase recruitment and retention efforts beyond media portrayal and multiple degree modalities (Allen, 2008; Auerbach et al., 2007; Beck, 2000; Rudel et al., 2009). Portrayal of nursing in the media coupled with many degree possibilities allowing entrance into bedside nursing practice is not enough to pull more working nurses into the field. Evidence demonstrates that longevity in the field and educational advancement throughout nursing careers are enhanced through integrating younger nurses into the profession (Cluskey et al., 2006; King et al., 2007; Rudel et al., 2009; Shepherd, 2008; Tremayne and Robson, 2008). Students that gain an interest and a belief of capability in a certain field are empowered to choose that particular career (Breeding,

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2008). Recruiting through informed career counseling could impact interest and self-efficacy in nursing. Existing literature demonstrates a poor perception of nurses from the public through media misperception (Donelan et al., 2008). Positive perceptions of nursing as a career have been documented in other research, but fail to explain the continued shortage of nursing graduates (Sand-Jecklin and Schaffer, 2006). Younger students starting their career have a higher chance of continuing through to a terminal degree and educating future generations (Allen, 2008). The impact of perception proves to be a necessary inclusion to future research efforts and has been integrated into this study's research. The Social Cognitive Career Theory (SCCT) is the major theoretical foundation for this study regarding career choice with variables of career interest, self-efficacy, and perception. With support gleaned from Social Learning Theory of Career Choice and Women's Career Development funneled into Bandura's Social Cognitive Theory, the SCCT was developed (Bandura, 1986; Coogan and Chen, 2007; Hackett and Betz, 1981; Krumboltz, 2006; Lent et al., 2002). This theory also assumes the importance of sociocultural and environmental contexts within factors affecting career choice (Lent and Brown, 1996). The conceptual framework for this study was the context of career choice as it relates to propagating the future of the nursing profession. Within the umbrella of career choice are the supporting antecedents of career interest, self-efficacy, and perceptions of nursing. These conceptual variables were chosen based upon findings from sound research and theory focused on enhancing knowledge of career decision-making. Fig. 1 gives this framework a visual appeal.

Methods Design This study was a quantitative ex post facto, comparative design using survey methodology. It used descriptive and inferential statistical analysis to report if any relationship existed between the variables of career interest, self-efficacy, and perceptions between undecided and nursing student groups.

Procedures The target population for this proposed research was undergraduate nursing and undecided students enrolled in a public midwestern university. The total sampling frame was 2000 undergraduate students in the undeclared and nursing majors. The subdivided sample had a significantly smaller number of enrolled nursing students of 277 versus the undeclared group with 1727. Due to the large difference in enrolled student population between nursing and undeclared students and the need to have an equal sample, a census of the entire enrolled nursing sample was used. A random sample of 300 students was used through the university admissions office, providing anonymity to the sample. With a voluntary survey collection, participants were able to access the survey link from any electronic device with internet access. The instrument adapted for this research, named the Career Choice Survey, was a combination of the Career Search Questionnaire (CSQ) (Roberts, 2008) and Perceptions of Professional Nursing Tool (PPNT) (Sand-Jecklin and Schaffer, 2006). This survey contained five demographic questions and 35 ordinal Likert-type questions. These questions were ordered in accordance with the research hypothesis, with variable-titled headings in order of career interest questions (10), self-efficacy questions (13), and public image questions (12).

Data Analysis Data was analyzed using SPSS software version 21.0.0 after importing from the electronic data collection tool. All responses remained anonymous and confidential. Reporting of responses was completed with descriptive statistics including measures of central tendency (mode, median, and mean), and variability (range, standard deviation, and variability). Hypotheses were addressed through analysis of questions subsets. Once normality in the data for each set was verified non-parametric, hypothesis testing was done to look for significant differences on the variable scores between the two groups of subjects. Due to the low sample size and non-parametric distribution of data, the Mann–Whitney U test was done to demonstrate significance between groups.

Fig. 1. Integrating SCCT with research variables.

V.M. Fillman / Nurse Education Today 35 (2015) 251–255

Results A total of 771 survey emails were sent with a possible 577 undergraduate respondents between the 300 undecided and 277 nursing undergraduates enrolled. A total of 78 surveys were collected, resulting in 68 usable surveys for analysis. Cronbach's alpha for this study resulted in a .80 value on career interest and .87 on self-efficacy subscales. Analysis for the perception subscale resulted in a score of .72 which is still considered acceptable for reliability (Munro, 2005). The total Career Choice Survey received a score of .83. The data collection tool collected demographics of age, gender, and major. The minimum age reported was 18 with a maximum of 56. The mean age was 21.78. Out of 68 respondents, 61 (90%) were female and 7 (10%) were male. Lastly, the demographics distinguished the sample between nursing or undecided major fields of study. The options available were nursing, undecided, or other. For the purposes of sample description and hypothesis testing, the other group was added to the undecided group. Of the 68 subjects, 45 (66%) were nursing and 23 (34%) were undecided. A closer look at the undecided group showed that about a third of the 23 undecided reported a major other than nursing or undecided. Table 1 displays measures of central tendency including mean and standard deviation for each subscale of the Career Choice Survey. Using the total score from the career interest subscale of the Career Choice Survey, nonparametric testing demonstrated a significant difference (p = .006) in career interest between groups of undecided and nursing students. Medians between groups demonstrate a higher value for nurses (45.92) than for the undecided (38.25) group. This value led to rejection of the first null hypothesis. Nonparametric testing between sample medians demonstrated a significant difference (p = .002) in self-efficacy between groups of undecided and nursing students. Medians between groups demonstrate a higher value for nurses (55.67) than for the undecided (46.80) group. This value led to rejection of the second null hypothesis. Nonparametric testing did not demonstrate a significant difference (p = .395) in perception between groups of undecided and nursing students. Median values between nursing (46.60) and undecided (44.00) were similar. This value led to a failure to reject the third null hypothesis. Discussion Demographics The U.S. Department of Education (2012) reports that in 2010, the greatest percentage (56%) of those enrolled in postsecondary education were between the ages of 18 and 24. The age distribution in this study is in line with other studies sampling the undergraduate population (Brodie et al., 2004; Dante et al., 2013; Sand-Jecklin and Schaffer, 2006; Seago et al., 2006). Born during the years of 1980 and 2000, most (N = 66) of this sample can be classified as “millennial's” (Stein and Sanburn, 2013). Characteristics of this generation include such stereotypes as narcissistic and entitled, but also opportunistic, optimistic, and entrepreneurial (Stein and Sanburn, 2013). In a time of instant gratification and living through a phone, computer, or tablet screen, this generation of potential research participants might have had better response rates if approached with a rewarding series of simple, but quick

Table 1 Descriptive statistics for career choice survey and subscales.

Career interest subscale Self-efficacy subscale Perception subscale Career choice total

N

Minimum

Maximum

Mean

SD

68 68 68 68

27 36 32 108

50 65 56 171

43.06 53.10 46.37 142.53

5.38 7.29 5.51 14.89

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surveys available through a social media network (Dillman, 2007; Gaffner and Hazler, 2002). A majority of the sample was female (90%) (N = 61). Females outnumber males in postsecondary education at 57% (The U.S. Department of Education, 2012).While not accounting for the advanced degree of female respondents in this study, it does assume that more women are in college and are therefore able to respond to survey requests in greater numbers than men. With U.S. averages between the sexes almost equal (51% female, 49% male) (U.S. Census Bureau, 2011), this disparity in gender responses could be attributed to the increased national average of women in the nursing profession (U.S. Department of Labor, 2003). In 2003, women made up 92.1% of the nursing workforce (U.S. Department of Labor, 2003). With a 66% (N = 45) nursing sample versus undecided (N = 23), the high ratio of females in this study supports statistics in nursing workforce. Respondents who chose the demographic option of major field of study (N = 68) displayed a greater percentage (66%) of nursing majors than undecided (24%). Auerbach et al. (2012) remark on the decline in nursing participation from 80% response rates in the 1980s to roughly 60% today. This research was specific to working nurses; older in biological age and not representative of this survey sample, but does demonstrate a possible explanation for both historically high response rates from nurses and the recent decline in participation rates (Auerbach et al., 2012). The undecided group is new to literature on career choices in nursing although literature does support postulations surrounding them. Staff et al. (2010) report that this undecided group is most often a product of uncertainty in high school, obligated to working while in school, and/or have family considerations affecting the timing and career outcomes in college. This “lack of career readiness” (Gaffner and Hazler, 2002, p. 317) could account for non-respondents. Without a defined career choice, this group may not have felt inclined to volunteer information. Research also supports the large number of undecided students within postsecondary education (N = 1727 enrolled at the data collection site) (Staff et al., 2010). The length of time in school without an intended major can be due to career experimentation or, as mentioned by Stein and Sanburn (2013) the sense of entitlement with millennials and the continued hope for a better opportunity or paying career. Theory also supports this stagnation in career decision. Social Cognitive Career Theory variables circulate around interest fed from self-efficacy in order to guide personal goals (Lent et al., 2002). If the millennial generation continues to take care of family commitments while working a non-career focused job in the hopes of gaining confidence and money for a large career opportunity, it is reasonable to expect them to linger in the undecided undergraduate phase. Hypothesis Discussion Ranging from new terminology, research, problem solving, and teamwork, career interest survey questions cover important concepts above and beyond patient care and could reflect adequate preparation into this career choice due to external influences (Lent et al., 2002; Roberts, 2008). Literature has mentioned unclear decisions in career choice with young adults (Feldt and Woelfel, 2009; Rehfuss, 2009; Sand-Jecklin and Schaffer, 2006), but this hypothesis test may show that by confirming interest in nursing, decisions are validated and can further future activity in the profession (refer to Fig. 1) (Lent et al., 2002). The undecided group was studied to add depth to research surrounding this concept important to both theory and practice. With a statistically significant value lower than the nursing group in interest, this not only supports the hypothesis that students who are currently undecided do not have an interest in nursing, but that their life experiences and exposure to careers have not led them to interest in a particular field (Gowans et al., 2009; Woolley et al., 2009). While theory states

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that the age of this sample (mean age of 22) is ripe for career decisionmaking (Lent et al., 2002), characteristics of this millennial generation could have affected their lack of exposure to career fields such as nursing (Stein and Sanburn, 2013). Operating in concert with cognition-of-self are the environmental factors (including social influences) necessary to support each individual in career decision-making (Lent and Brown, 2013). Capitalizing on the high self-efficacy of the nursing sample, nurse educators have a responsibility to mentor this population with modeling, counseling, and positive career behaviors. Reinforced self-efficacy throughout nursing as a career can continually develop greater interest in advancing though nursing education (Gibbons et al., 2011; Hackett et al., 1992; Roberts and Ward-Smith, 2010). Bandura (1986) defined self-efficacy as belief of self to successfully execute a skill or behavior, indicating self-efficacy accomplishment at any age. With the sample size (N = 68) in this study, it is difficult to generalize this finding beyond this group of undergraduate students. The young mean age (22) and generation-labeling could indicate that perceived self-efficacy has either not developed for some participants, or has developed at this young age and solidified with choice in nursing. Young populations seeking career choices could be exposed to external influences regarding nursing (such as social support or exposure to working nurses) that could affect efficacy and interest in the profession to support recruitment and demonstrate an increase in these variables with an increase in age and experience. With the exception of Seago et al. (2006), research has found that individuals in nursing careers, nursing students in various degreegranting programs, and non-nursing students have held a generally low perception of nursing themselves as well as felt that the public views nursing poorly (Brodie et al., 2004; Dante et al., 2013; Donelan et al., 2008; Sand-Jecklin and Schaffer, 2006; Takese et al., 2006; Whitehead et al., 2007). In this case, all respondents had a relatively high feeling that the public values the profession of nursing. Perception subscale questions on the Career Choice Survey that received higher ratings than others included such concepts as professionalism, respect of nursing, positive image, valuable, and important to the healthcare team. These findings are an indication of change as they differ from previous research reporting a negative image of nursing; seen as a skill-based career (O'Brien et al., 2007). With no statistical significance demonstrated here, the undecided sample is exhibiting a greater understanding of the profession than they have in the past, although growth opportunities are noted within certain areas already mentioned, such as complexity. The external effects of perception are an important aspect to the decision to go into and remain in a nursing career (Brodie et al., 2004; Dante et al., 2013; Lent et al., 2002; Lovan, 2009; Seago et al., 2006; Sand-Jecklin and Schaffer, 2006; Takese et al., 2006). Continuing to correct perceptions in nursing could have an impact to the nursing shortage by influencing career interest in a field developed by positive public image. Limitations This study was limited by methodological and practical concerns. A low response rate from the undecided sample fell below reasonable testing limitations with only 23 respondents. This, in addition to the 45 nursing respondents, gave the total study's sample a number of 68 and diminished generalizability to the undergraduate population. Small samples and an abnormal distribution of the data led the researcher to choose non-parametric hypothesis testing, which diminished the strength of the results (Polit and Beck, 2008). Intermediaries used as a requirement of the data collection site could have impeded the flow of information to potential research candidates. Although the sample age was consistent with national averages of college students, the young age of the respondents homogenized the results making it difficult to generalize to second-career students or those currently in the workforce facing career choice decisions. A restriction

on demographics collected limited generalizability and connection with theory support to expansion with minority races. Recommendations Results of this research are intended for use with increasing recruitment and retention to the nursing profession. Increases in career counseling to high school and college hopefuls should be made to include accurate representation of nursing. Continued testing with current nurses on the variable of self-efficacy could affect retention and encourage continued education in the field. Both avenues of approach would impact the nursing shortage through recruitment of younger populations and retention of qualified persons. Career choice has yet to be studied expansively with nursing hopefuls and younger generations. The effects of the social media explosion and their impact to perception in career choice have unlimited potential. SCCT inclusion will guide future researchers on the effects of theory concepts to this population, increasing understanding and clarifying counseling need. Healthcare reform is also in the midst of change in a burdened economy. How this affects the retention of qualified nurses could be studied with self-efficacy and perception concepts. The public views of nursing have the potential to change during a time of increasing responsibility and autonomy. Self-efficacy remains an absolute factor of outcome expectation and goal attainment (Lent et al., 2002). Repeat testing of this variable could encourage graduate school admission for current nurses. Expansion of the Career Choice Survey to undergraduate students in different geographic areas and inclusion of demographic variables, such as race, would expand the generalizability of the current results. Testing with this instrument to high school students could guide career counselors to encourage high-scoring students into the nursing profession. Conclusion With a basis in theory and formed with tested instruments, the Career Choice Survey was tested with a subdivided undergraduate student sample on the variables of career interest, self-efficacy, and perception in nursing. Findings from the quantitative data analysis conclude a high degree of interest and self-efficacy in the nursing groups when compared to the undecided group. Perception as a variable did not differ between groups and guides future practice opportunities in increasing awareness of the profession though media and counseling efforts. Increasing age was found to correlate to a decrease in perception, placing value in early recruitment opportunity. Supporting previous findings, this study adds to the body of literature surrounding career choice and fills a gap with perception addition and undecided student group testing. Limited in sample size and demographics, future studies are recommended to increase generalizability to undergraduates and minority populations. The nursing shortage will continue unless research is undertaken to increase understanding and promote nursing as a profession worthy of support. References Allen, L., 2008. The nursing shortage continues as faculty shortage grows. Nurs. Econ. 26 (1), 35–40. American Association of Colleges of Nursing, 2013. Media relations: nursing shortage Retrieved from http://www.aacn.nche.edu/media-relations/fact-sheets/nursingshortage. American Nurses Association, 2013. Nursing shortageRetrieved from http://www. nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/workforce/ NursingShortage. Auerbach, D.I., Buerhaus, P.I., Staiger, D.O., 2007. Better late than never: workforce supply implications of later entry into nursing. Health Aff. 26 (1), 178–185. http://dx.doi.org/ 10.1377/hlthaff.26.1.178. Auerbach, D., Staiger, D., Muench, U., Buerhaus, P., 2012. The nursing workforce: a comparison of three national surveys. Nurs. Econ. 30 (5), 253–261. Bandura, A., 1986. Social Foundations of Thought and Action: A Social Cognitive Theory. Prentice Hall, Englewood Cliffs, NJ.

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Career interest, self-efficacy, and perception in undecided and nursing undergraduate students: a quantitative study.

Career choice variables of career interest, self-efficacy, and perception were chosen based upon Social Cognitive Career Theory concepts for study bet...
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