Associate degree nursing

Professional values held by baccalaureate and associate degree nursing students

Martin P, Yarbrough S, Alfreed D. Professional values held by baccalaureate and associate degree nursing students. J Nurs Scholarship. 2003;35(3):291-296.

Advances in technology and expanding roles create complex ethical and moral dilemmas for nurses. Modification of personal values and internalization of professional nursing values are both important parts of ethics development in nursing education. In 1991, content related to essential values was not routinely included in formal nursing curricula, but was taught informally through unplanned discussions. The values of the nursing profession are found in their professional code of ethics. Several studies regarding values development for baccalaureate students and faculty have been conducted and have concluded that nursing faculty ranked values of equality, human dignity, and freedom higher than nursing students did, and also that nursing students made significant improvements in moral reasoning between enrolling and graduating from these programs. However, researchers acknowledged that the specific effect of nursing curriculum on moral reasoning was unknown. In addition, little is known about associate degree nursing students' values development process. This study was designed to determine whether or not differences in values existed between baccalaureate and associate degree nursing programs in Texas.

One thousand four hundred fifty senior nursing students from 25 baccalaureate and 16 associate degree nursing programs in Texas participated in the study. Demographics included male and female students, Caucasian, African American, Hispanic, Asian/Pacific Islander, and Native American students, and students of other ethnic backgrounds. Students between the ages of 20-29, 30-39, 40-49, and over 50, and students who were married, single, divorced, and widowed were also included. Participants rated their values utilizing the Nurses Professional Values Scale (NPVS), a 44-item, norm-referenced instrument with a Likert scale ranging from 5 (most important) to 1 (not important). The NPVS has 11 subscales, each corresponding to 1 of the 11 value statements in the 1985 Americ.-Ji Nurses' Association Code for Nursing. The investigators found that there was no overall significant difference between students in Associate Degree in Nursing (ADN) and Bachelor of Science in Nursing (BSN) programs. However, there were significant differences in several of the subscales of the NPVS. Senior ADN students scored higher than the BSN seniors in 5 of the 11 subscales. Other differences were not program related, but rather based on sex and ethnicity. Male students from both programs scored lower on the NPVS than did female students from both programs. There were no differences identified on the NPVS based on age. Scores by ethnic group did not differ overall on the NPVS; however, they did differ on three subscales. In the category of marital status, the only significant difference was that divorced students scored higher than married and single students on one subscale.

The current health care environment requires that nurses possess the ability to manage complex ethical dilemmas. This study was conducted to determine whether or not differences in professional values existed between BSN and ADN students in Texas. While students did not differ significantly on the total NPVS scores, ADN students scored higher than BSN students on 5 of 11 subscales and men from both programs scored significantly lower than women on the total scales as well as each of the subscales. Ethnic groups differed in three subscales. The authors suggest that future research designs include replicating the study with a sample of nursing students from throughout the United States, as well as conducting a longitudinal study of students entering and completing nursing programs.

Randi Woodrow, PT

VA Greater Los Angeles Healthcare System

West Los Angeles Healthcare Center

Los Angeles, Calif