Political Astuteness and Beliefs Among Senior-Level Baccalaureate Nursing Students: A Mixed-Methods Approach

Purpose: The Essentials of Baccalaureate Education for Professional Nursing validates the importance of the baccalaureate nurse being prepared to participate, and become an advocate in health policy. Therefore, nurse educators play a vital role in laying the foundation for nursing students to understand and engage in health policy. Little research has explored the effects of health policy educational activities in senior-level pre-licensure baccalaureate nursing students prior to graduation. The purpose of this study was to assess if senior-level pre-licensure baccalaureate nursing students increased their political astuteness score after exposure to policy related course work during their last semester. Additional exploration looked at how nursing students would engage in health policy after graduation.

Methods: A convenience sample of senior-level baccalaureate nursing students enrolled at one private institution in the Northeast were recruited to assess if the various health policy activities impacted their political astuteness over the course of the spring semester. Educational activities included a day at Capitol Hill, writing a letter to a local representative, a sub-systems assessment for health policy using an online simulation, and a health policy lecture. Participants completed the Political Astuteness Inventory (PAI) at the beginning of the spring academic semester and two weeks before the end of the semester. In addition, nursing students completed several demographic questions and three open-ended questions on Qualtrics.

Results: The one group pretest/posttest consisted of participants (n=38) that were primarily non-Hispanic Caucasian females between the ages of 21-23 years. A paired t-test revealed that nursing students had an increased total score on the PAI from the beginning of the semester (M=7.5, SD 5.4) to the end of the semester (M = 16.6, SD = 7.4; t(37)= -9.0, p < 0.00). Nursing students had an increased awareness of issues in health policy (p < 0.00), how to contact a lobbyist (p < 0.00) and the legislative process (p < 0.00), and became abreast in literature published by their state nurses’ association or other literature (p < 0.00). There was not an increased interest in public health issues by the end of the semester (p= 0.09) or voter registration (p = 0.32). Nursing students found writing a letter to a representative was the most beneficial activity to enhance their learning. In addition, interacting with a lobbyist or meeting with a representative were suggestions to add in order to promote a deeper learning of health policy. A content analysis revealed the themes of advocacy, education, and awareness were opportunities to enhance the nursing science after graduation.

Conclusion: Results from this study indicate that nursing students did become more politically astute over the course of the academic semester. Insight from the open-ended questions provide an opportunity to implement new teaching pedagogy and reinforce mentoring of nursing students to increase their knowledge about health policy prior to graduation. Further research should explore the political astuteness of nursing students after graduation as they transition into the professional nurse.