Caring is one of the core values of nursing (Labrague, et al., 2015; Landers, Weathers, McCarthy, 2014; Li, et al., 2013; Wade & Kasper, 2006 ). As nurses focus more on increasing their technological competencies in today’s complex healthcare environment, there is concern that caring may be minimized or lost (Grobbel & Rowe, 2014). Studies suggest that nursing instructor support has a positive influence on student success (Ahn & Choi, 2015; Del Prato, 2013; Rowbotham & Owen, 2015). Understanding what behaviors demonstrate caring to students can help nurse educators develop and utilize more of these caring behaviors in various interactions with students. This can help develop the instructor-student relationship, and potentially help students succeed in nursing school and in the profession.
Methods:
The aim of this study was to explore associate degree nursing (ADN) students’ perceptions of instructor caring, and the relationships between age, employment status, and race/ethnicity with these students’ perceptions. This quantitative study used a non-experimental survey design. The target population was second-year students in ADN programs. The convenience sample consisted of fourth quarter nursing students from five ADN programs in a northern state. The research questions were:
- What is the relationship between nursing student age, employment status, and race with nursing students’ perceptions of instructor caring?
- To what extent are the factors on the NSPIC instrument for students’ perceptions of instructor caring related?
- What (if they could) would nursing students change about their nursing instructors’ caring behaviors?
The instrument used was the Nursing Students’ Perception of Instructor Caring (NSPIC) (Wade & Kasper, 2006). This instrument was based on Watson’s (2001) Theory of Transpersonal Caring. The 31-item six point Likert scale instrument contains five factors reflecting transpersonal caring in nursing education. The five factors identified in the instrument are: instills confidence, supportive learning climate, appreciation of life’s meanings, control versus flexibility, and respectful sharing (Wade & Kasper, 2006). The NSPIC instrument has been used in five additional pre-licensure nursing research studies that have been published in peer reviewed journals (Ali, 2012; Labrague, et al., 2016; Li, et al., 2013; Meyer, Nel, & Downing, 2016; Zamanzadeh, Masoumeh, & Palmeh, 2015).
In the fall of 2018, internal review board approval was obtained and permission was received from each nursing program Dean or Director to administer the NSPIC instrument to students. The survey was completed on students’ digital devices. Research question one was assessed with multiple regression. Research question two was assessed with multiple correlation. Research question three was an open-ended question that was used to gain insight into the quantitative data.
Results:
The total number of second year students in these five programs was 232. Survey data were collected from 161 students, a 69% response rate. Although there were no statistically significant findings related to age, employment status, and race, the narrative comments helped highlight students’ perceptions related to these variables. There were positive correlations between students’ perceptions and age and race. There were negative correlations between students’ perceptions and employment status. The majority of narrative comments related to the supportive learning climate scale, which was ranked fourth overall. Themes included feedback, communication, availability, and support.
There were strong, positive, and statistically significant correlations between all of the scales within the NSPIC survey. The students’ narrative comments addressed all NSPIC scales except appreciation of life’s meaning. When considering the factor structure, there were some statements that, if removed from a scale, would make the scale perform better. This may be a matter of the item fitting better in a different scale, or a need to reevaluate the factor structure.
Conclusion:
There are implications for nursing instructors based on the results of this study. Students are individuals with various learning styles, life experiences, and preferences. It is important for nursing instructors to be flexible and consider the needs of each student and each class. For example, instructors can ask for ongoing feedback, consider having students complete learning style inventories, or meet one on one with students in their clinical group. Although it is not possible to meet every student request, instructors can review feedback trends, vary teaching methods to address all learning styles, incorporate greater flexibility with office hours, and implement changes when possible. These are various examples of role modeling instructor caring. This can help build the instructor-student relationship, develop trust, demonstrate flexibility, and show support.
Other examples are reflective of learner-centered teaching strategies (Doyle, 2011). This may include allowing students to help develop course policies, set due dates, or determine acceptable topics for papers and projects. Additionally, it could include having students participate in developing specific learning outcomes, rubrics for peer evaluation, and discussion guidelines.
Nursing is a caring, holistic profession, but the data do not indicate that nursing instructors are perceived as strong role models of caring as perceived by their students. Nursing instructors must be leaders for the profession. Instructors’ actions toward students can ultimately effect patient outcomes as students become professional nurses.
This study has helped to identify areas of instructor caring that students perceived as lacking, specific behaviors and themes that can be addressed, and potential examples of evidence based teaching practices that may also assist in demonstrating caring. Increasing perceived instructor caring and support through positive instructor behaviors, quality teaching, and role modeling can lead to student success, including greater caring self-efficacy, and socialization to the professional role (Rowbotham & Owen, 2015; Shelton, 2012). Nursing instructors must care for their students, so they in turn can care for their patients.