The “values journey” of nursing and midwifery students selected using multiple mini interviews; year two findings

Abstract

Aim To explore how adult, child, mental health nursing and midwifery students describe their “values journey” after completing their second year following exposure to the clinical practice environment. Background Where student nurses and midwives are selected using multiple mini interviews, in a values‐based recruitment process, the conservancy and or development of their personal values remains unclear. Design A hermeneutic, cross‐professional longitudinal study was commenced at one university in England in 2016 with data collection points at the end of years one (DC1), two (DC2) and three (DC3). From the 42 participants recruited in year one, 28 went on to participate in data collection at DC2 (3 adult, 6 child, 3 mental health nurses and 16 midwifery students). Methods Four semi‐structured focus groups were conducted. Data analysis incorporated inductive and deductive approaches in a hybrid synthesis. Findings Participants did not feel their values had changed fundamentally since year one. However, the prioritization of their values and how they were “put into practice” had changed. Key themes identified were: “changed sense of self as a healthcare practitioner”; “influences on values in practice” and “reflection on values.” Conclusion Reframing of personal values is an integral part of learning across clinical and academic settings. Critical reflective practice should be integrated into pre‐registration health education programmes to support student nurses and midwives sustain their learning around values; to maintain “good” values in the face of observed “bad” values.

The ‘values journey’ of nursing and midwifery students selected using multiple mini interviews: Evaluations from a longitudinal study

“…Themes found in the third and final year of the study are discussed in the context of findings from previous years (Callwood et al, , ). Quotes are from year 3.…”

“…A longitudinal study exploring the ‘journey’ of adult, child, mental health nursing and midwifery students commenced in 2016 and took place over the duration of students' 3‐year education programme. Preliminary results were published in 2017 and 2018 (Callwood, Bolger, & Allan, ; Callwood, Groothuizen, & Allan, ). This paper presents our final findings, overview and evaluations regarding the study, and provides recommendations.…”

“…This process engages with and changes existing practices and experiences (Evans, Guile, Harris, & Allan, ), implying that student nurses and midwives are constantly ‘broadening their horizons’ through their educational and clinical encounters (Callwood et al, ). Students' accumulating knowledge, in response to the challenges and dilemmas that they inevitably face over the duration of their education programme, can be transformative (Mezirow, ) in relation to their values (Callwood et al, ).…”

“…We have previously shown that student nurses and midwives can change and reprioritise their values after commencement of their programme and gaining clinical practice experience (Callwood et al, , ). Knowledge and confidence improved from the first to the second year, but the greater level of responsibility and organisational pressure experienced in the second year challenged compassion and patient‐centeredness (Callwood et al, ).…”

“…We have previously shown that student nurses and midwives can change and reprioritise their values after commencement of their programme and gaining clinical practice experience (Callwood et al, , ). Knowledge and confidence improved from the first to the second year, but the greater level of responsibility and organisational pressure experienced in the second year challenged compassion and patient‐centeredness (Callwood et al, ). Evidence from the field of medicine (Hojat et al, ) suggests that, particularly in the demanding final stage of students' education programme, idealism and empathy may erode, due to factors such as a challenging curriculum, time pressures, a hostile environment, exhaustion and a fear of making mistakes.…”