Table 3 Education framework of professional values for undergraduate nursing students
Framework | Content | ||
|---|---|---|---|
Education objectives | Overall objective | Students can gradually grow and internalise their professional values and fully recognise and understand the humanistic sentiments and moral emotions embodied in professional nursing values Students can base their professional values on guiding their attitudes and behaviours during clinical practice to make them conform to professional ethics and morals | |
Level objectives | Acceptance | • Students are able to recognise the meaning and significance of personal values and are aware of their importance and their relationship to personal growth and development; • With the instructor's guidance, students can attempt to describe and clarify their personal values; • Students are able to learn about the history of the nursing profession, express their concern for the profession, recognise outstanding figures in the nursing profession in China and abroad, and are willing to learn about their contribution and value to the profession through the instructor's explanation | |
Reactivity | • Students are able to read books related to life values carefully, actively participate in reading and communication activities, and share their experiences; • Students are able to actively seek out their professional role models and try to imitate their behaviour; • Students recognise the future direction of the nursing profession and actively make study plans and career plans | ||
Forming values | • Students are able to recognise the nature of life, respect its meaning, and pursue its values; • Students are able to understand the values of the nursing profession and explain the connotation, meaning, and importance of nursing professional values; • Students are able to clearly articulate what they consider to be the order of importance of nursing professional values and the reasons for them; • Students are able to recognise the importance and significance of nursing professional values for professional development and form a stable • Students are able to clearly articulate the order of importance of their professional values and the reasons for them | ||
Organizing the value system | • Students are able to point out the relationship between professional nursing values and clinical nursing practice and are able to identify the embodiment of professional nursing values in practice; • Students are able to integrate professional values into their personal value system based on their attributes and solve dilemmas that they may face in clinical nursing practice based on their professional values | ||
Personalization of the value system | • Students are able to give judgments based on their value system about various situations in the nursing practice environment that is in line with their professional values; • Students are able to consciously provide nursing practice activities that are in line with their professional values | ||
Education process and content | The initial stage—building the roots of professional nursing values | • In-class: life values education The nursing profession is concerned with the cycle of human life care, and it is therefore vital that students are guided to understand the nature of life, respect the meaning of life, and pursue the value of life in the early stages of the formation of professional values. Life values education needs to be combined with different nursing professional courses, such as Nursing Ethics, to realise the education of life values, life emotions, life responsibilities, and life meaning, thus laying the foundation for developing professional values | |
• Out-of-class experiences: personal values awareness and clarification The instructor uses extracurricular activities to guide students in understanding the concept, meaning, and importance of values; identifying the relationship between values and personal growth and development; recognising the need to form and internalise professional values in nursing; and clarifying personal values. Specific formats include community service and personal growth story-sharing workshops | |||
The consciousness stage—enhancing the sense of belonging to the profession | • In-class: learning the history of the development of the nursing profession After entering the nursing profession, undergraduate nursing students begin to gradually get to know and understand the nursing profession and gradually form a professional identity through studying professional-related courses. In the consciousness stage of the growth of professional values, individuals need to form a sense of professional community and have a sense of belonging to the profession. Therefore, learning the history of the development of the nursing profession could help understand the development process and experience of the nursing profession, empathise with the contribution of nursing predecessors to the development of the profession, form firm professional beliefs, and lay the foundation for internalising professional values | ||
• Out-of-class: finding and sharing professional role models Students read autobiographies and books on nursing, find their role models, try to imitate and create role model behaviours, and share them with their classmates, who will then comment on and share them. Specific forms of sharing include an online micro-video applet as a sharing vehicle to showcase current role models in life that students admire and learn from and explain why,such as online short video personal role model sharing competition | |||
The core stage -Professional Experience Immersion and Professional Values Embodiment | • In-class: learning professional nursing values This stage focuses on learning the connotations of professional nursing values. Each values is taught to the professional curriculum, and each of the nine attributes is discussed and studied to how human dignity, care, altruism, responsibility, equality, justice, honesty, action, and autonomy are reflected in the work of clinical nursing practice. Teaching methods include special lectures, deed reports, service learning, film viewing, and group discussion | ||
• Out-of-class: case reflections on nursing professional values Scenario-based teaching is added to design clinical situations, problem situations, and discussion situations that address the relationship between nursing professional values and clinical nursing practice, demonstrating the nursing professional values in that situation, such as in the care of elderly or AIDS patients. Also, for students experiencing clinical internships, clinical experience sessions are held to share positive and challenging experiences of professional values demonstration that exists during practice | |||
The Action stage—integration of personal development and professional futures | • In-class: learning about the future development of the profession and career planning This stage is an active process in which the professional values of nursing are continually deepened and internalised. The future development of the nursing profession is explained, including specific topics such as nursing-related policies, future career development, and career planning design | ||
• Out-of-class: drawing a blueprint for personal future development The students will be able to draw up a blueprint for their future development by writing a personal plan in which they will set their personal career planning goals for the next 5 to 10 years, the conditions for completion, the process and ways to achieve them, and possible challenges and ways to overcome them | |||
Environment and conditions | Internal conditions—reflection and breakthrough | In the growth of professional values in nursing, individuals must reflect continuously, break through the confusion of the growth phase of life, and integrate professional ideals with professional reality. This process requires an internal drive toward self-acceptance to develop professional values; therefore, the internal conditions are self-reflection by students and self-monitoring. With a critical understanding of the prejudices and stereotypes for nursing, they examine the profession's strengths, improve their professional practice skills, form professional self-confidence, and identify with nursing professional values, thus providing the internal conditions for the growth and internalisation of nursing professional values | |
External conditions—a supportiveenvironment | Instructors | Instructors' companionship and positive motivation are essential in forming and internalising students' professional values. Class tutors are set up as needed to understand the individual situation of each student in the class and provide positive motivation. Care can be passed on to each other, and instructors need to be selfless in their care for their students, which permeates the student-instructor relationship in small ways. Instructors need to learn to think differently and be able to put themselves in the shoes of students at a stage of conflicting professional identities and try to help resolve them. At the same time, the instructor's image is also the image of the nursing profession in the students' minds, and its subtle influence is felt in forming their professional values | |
The humanistic environment of the school | The school should strengthen the cultural construction of the college, set up decorations with the characteristics of the nursing profession, and highlight the cultural connotations of the nursing profession, such as placing a statue of Nightingale, hanging the college motto, and decorating the humanistic nursing gallery. Creating a supportive interpersonal environment where students and instructors help each other is also necessary | ||
The humanistic environment of the college | The college should create a humanistic environment that conveys respect and recognition for all professions and treats students of all professions equally | ||
Evaluation | self-evaluation | Process evaluation | • One-to-one interview: Set up a stage interview outline for the four stages of the key aspects of the growth of professional values of undergraduate nursing students. ① The initial stage: What do you think it means to you to clarify your personal values? How do you think your personal values have influenced your understanding of the nursing profession? ②The awareness stage: How do you view the nursing profession now? What role do you think life role models play in the growth of your professional values? ③The core stage: What do you consider the professional values of nursing? How do you think nursing professional values are reflected in clinical practice? Please give a specific example. ④ The action stage: What do you think are the strengths of your future career in nursing? Please talk about how career planning has contributed to the growth of your professional values • Nursing professional values reflection diary: Based on the content of the attributes of nursing professional values, namely human dignity, care, altruism, responsibility, equality, justice, honesty, action, and autonomy, and taking into account the training process, the reflection diary topics are designed, including seven topics, namely "The value and dignity of life", "The meaning of care in the nursing profession", "How to face disciplinary incidents in nursing", "What should I do if I meet a patient with AIDS", "What is the meaning of caring in the health care field", "Talking about what is justice in health care", "What I know about the nursing profession", "My future career". The reflective diary provides a complete understanding of students' knowledge and understanding of professional values. Through students' written expressions, they can further internalise professional values in the process of self-professional values clarification |
Summative evaluation | • Nursing professional values measurement: This study used the Revised Nursing Professional Values Scale to measure professional values • Focus group thematic interview: The focus group interview included two aspects: first, what insights were gained about the learning of professional values, what elements were considered to be beneficial, what elements needed to be adjusted, and what other aspects were considered necessary to strengthen the understanding of professional values; second, talk about the understanding of nursing professional values and what personal, professional values are like | ||
Instructor evaluation | Process evaluation | • Observation method: To ensure the overall quality of professional values development, instructors need to evaluate the effectiveness of various teaching processes in infiltrating professional values into class and extra-curricular activities and complete a instructor observation manual. The manual is self-designed, and its content needs to be adjusted according to the range of professional nursing courses and the lecturer's requirements, mainly the educational objectives, educational process, teaching methods and strategies of the in-class, and the degree of student participation | |
Summative evaluation | • Interview method: Instructors were asked to make personal summative evaluations of students throughout the professional values growth phase, explaining how instructors played a role in supporting students' professional values growth | ||