Changing student nurses values, attitudes, and behaviours : a meta ethnography of enrichment activities
Objective: The process of changing student nurses attitudes, values, and behaviours so that they become congruent with the profession are neither easy nor successful in all cases. This paper will clearly highlight to the reader the conditions necessary in order to both optimise teaching activities and measure the degree of change in the affective domain of student nurses.
Method: The aim of the meta-ethnography was to analyse and synthesize literature on the impact of four undergraduate pre-registration programme enrichment activities (Inter-professional learning, International placements, simulation, and blended learning) on the affective domain development of student nurses. A systematic search of the literature identified qualitative studies using explicit criteria. Key concepts were identified and translated across the studies, by using a recognised framework that measured changes in values and attitudes: compliance, identification, and internalisation, from the collective views of the participants. The findings created a line of argument synthesis from the developed tables and mind maps.
Results: Data were synthesised from twenty nine papers, across seven countries, with more than 755 student nurse participants. Reciprocal translation highlighted teaching activities that created significant modification in affective domain development, resulting in the internalisation of learning, were those that introduced the nursing students to a new patient, personal or professional culture via an international placement or an inter-professional training programme.
Conclusion: The final synthesis presents conclusions not evident in the primary studies. To develop students so they have attitudes and values congruent with the profession, academics and registered practitioners need to focus on creating enrichment activities alongside the regular curriculum that are: based on cultural issues that challenge beliefs and assumptions, either immersive or repeated for more than 6 weeks, based around or in clinical practice, and provide regular opportunities for premise reflection with experienced staff.