Education Versus Employability: A Disparity

 

Avani Oke¹, Mr. Mohd Atif²

¹Principal, K. J. Somaiya College of Nursing, Sion, Mumbai.

²Lecturer, K. J. Somaiya College of Nursing, Sion, Mumbai-400022.

 

ABSTRACT:

Background and objectives: Nursing education is currently facing challenges related to the application of nursing knowledge in clinical environments and inability of students in application of nursing procedures in clinical settings. Personal experience as an administrator and professor in the nursing education field has showcased that the current nursing education lags the expectations of the hospital authorities. The employers and hospital administrators require retraining and preparing nurses through orientation and induction before placing them on floors for patient care. This entails additional responsibility and requires additional time and energy. It also results in loss of actual nurses that could be made available for patient care. The objectives of the study were to identify the strengths, weaknesses of an institute towards nurse FIT and to assess the overall FIT and identify the remedial measures to be instituted. Material and Methods: A descriptive, exploratory survey research approach was used. Purposive sampling technique was used to select the samples. The sample consisted of 74 final year students from GNM and Basic B.Sc nursing students. Online Self reporting questionnaire was used to collect the data. Results: The results revealed that the nurses were having an average score in the following attributes: collaboration (51.35%), decision making (44.59%).In the attribute of adaptability, about 79% of the nurses have score between 51 to 70 where as 76% of nurses have emotional intelligence score between 51 and 70.Approximately 96% of the nurses have an overall FIT score between 51 and 70. The competencies that had a good percentage of average score were maturity(56.76%),Customer Service(83.78), Decision making(72.97), Self control(66.22%0, hygiene(58.11%), safety(68.92%). The gap in the attribute of high and average score of the nurse was maximum for accountability, emotional intelligence, decision making and patient focus. The gap is minimal in quality focus area, collaboration and adaptability. Conclusion: To conclude, it is seen that the education provided has gaps. The education needs to take remedial measures to empower the nurses to develop attributes like accountability, emotional intelligence, decision making and patient focus. The competencies that require attention are: flexibility, system driven and sensitivity and handling stress and tensions.

 

 

 

 

 

 

 

INTRODUCTION:

“Education is our passport to the future, for tomorrow belongs to the people who prepare for it today.” (Malcolm X)

 

As said by Malcolm, it is true that knowledge and future go hand in hand. We need to look into future and have to build a strong base if we want a brighter tomorrow. Nursing is a unique profession that requires all the three components of education, cognitive, psychomotor and behavioral. These three components if not blended in the right proportion will lead to heterogeneous mixture, thus the importance of education.

 

NEED FOR THE STUDY:

With the advent of technology, emergence of newer diseases, hospital accreditation, automation, specialization and newer demands of society, nursing is going through a lot of changes. The nurse is now expected not only to care for the client but expected to be an advocate, educator, counselor and more accountable for patient safety. She requires to be abreast of the newer trends in medicine, computers and specialize in the clinical field. Nursing education is currently facing challenges related to the application of nursing knowledge in clinical environments and inability of students in application of nursing procedures in clinical settings.

 

Many studies have indicated a need for the nursing education system to keep pace with continuous changes in nursing practice. The literature suggests that the results of apprenticeship are not satisfactory, which is indicated the need for more attention to this aspect (Adami& Kiger, 2005). Although new nursing graduates possess a strong theoretical background and knowledge, but they don’t have the necessary skills and dexterity that are required to solve problems that arise in clinical settings. Some studies have also indicated the existence of a vast gap between classical nursing and obstetric education and clinical care performance, suggesting that the present clinical education system does not provide students with the necessary clinical skills. (Hadizadeh, Firoozi, & Shamaeyan-Razavi, 2005).

 

A systematic approach to education is needed to facilitate the student to bridge theory, research and practice as well as create a starting point for reflection (Martin & Mitchell, 2001). It then becomes the responsibility of the student to utilize the system, seriously reflect and ultimately be accountable for their learning.

 

Personal experience as an administrator and professor in the nursing education field has showcased that the current nursing education lags the expectations of the hospital authorities. The employers and hospital administrators require to retrain and prepare nurses through orientation and induction before placing them on floors for patient care. This entails additional responsibility and requires additional time and energy. It also results in loss of actual nurses that could be made available for patient care.

 

The investigator therefore felt it necessary to assess the lacunaes in nurses based on the required qualities and identify the reforms necessary to improve nursing in totality.

As an investigator, it was felt that there is an urgent need to ensure that adequate preparation is done by assessing the quality of education. The nurse educators could reform and prepare nurses to ensure that they have minimum qualities that are required for nursing.  The researcher felt that examination of students in key qualities of a nurse would help an individual nurse to identify her lacunae and provide her the remedial measures for self improvement. The investigator also felt that such a study on the students would also assist the educational institute for instituting reforms and for the hospital sector to fit the right candidate for the right job.

 

PROBLEM STATEMENT:

A study to assess the nursing FIT in selected nursing institute.

 

OBJECTIVES:

1.     To identify the strengths of an institute towards nurse FIT.

2.     To identify the weaknesses of an institute towards nurse FIT.

3.     To assess the overall nurse FIT of an institute.

4.     To identify the remedial measures to be instituted for better nurse FIT.

 

Operational Definition:

1.     Assess:

In this study, assess refers to evaluating the nursing FIT (strengths, lacunae and reforms) provided by the selected institute for a batch of students.

2.     FIT (Focused integrated training):

FIT refers to the nursing training provided by the selected institute towards preparing nurses by implanting the governed curriculum. Nursing fit is assessment of competencies and attributes that are a core for nursing practice.

 

The competencies that would be assessed were: Accountability, collaboration, adaptability, emotional intelligence, decision making, patient focus, quality focus, stress management.

 

The attributes that were assessed were: maturity, time management, flexibility, system driven, team player, interpersonal relationships, social warmth, sensitivity, decision making, customer service, self control, hygiene, safety and handling tension.

 

3.     Nurse:

In this study, nurse refers to a student who is undergoing the training (Diploma/ degree) and is at present studying in the final year.

 

Assumption:

1.     Assessment of attributes of a student is a reliable tool for identifying the quality of nursing.

2.     Personal attributes, competencies and practice go hand in hand.

3.     Self reporting is a reliable tool for data collection.

4.     Students will provide reliable data.

5.     Nursing training would prepare professional, efficient nurses who are able to function independently as staff nurses.

 

Delimitation:

1.     The study findings are restricted only to one selected nursing institute.

2.     The study is confined only to the students studying in the final year of nursing program.

3.     The qualities are assessed only through self report and at a single point of contact.

 

Research Approach:

Descriptive, exploratory

 

Research Design:

Survey

 

Setting of the study:

The study was conducted on 10^th and 11^th August 2018 in the computer laboratory.

 

Population:

All students undergoing training in the selected institute.

 

Sample:

It consisted of students who were studying in the final year of nurse preparation program.(3^rd yr GNM and 4^th Yr Basic B.Sc Nursing)

 

Sample size:

Total sample size was 73. It consisted of 29 GNM and 44 B.Sc nursing students.

 

Sampling technique:

Purposive sampling technique was utilised.

 

Inclusion criteria for sample selection:

1.     Student who is studying in the final year of the selected institute.

2.     Student who is able to operate basic computers and able to read, understand English.

 

Exclusion criteria for sample selection:

1.     Students other than those studying in the final year of selected institute.

2.     Students who are unable to read and understand English and unable to operate the computers.

3.     Students who were not present on the day of data collection.

 

Tool for data collection:

Online Self reporting questionnaire

 

Tool description:

The questionnaire used was in online mode. The questions checked the competencies and attributes through a series of questions that had multiple choices.

Technique for data collection:

Self reporting technique was used for data collection.

After completion of one batch, the next batch was taken. Care was taken to see that the students who had undertaken the test would not interact with the next batch of students. Total 4 batches were taken for data collection.

 

Validity:

Content validity was ensured. The tool was prepared and validated by experts from various fields.

 

Talent Assessment & Analytics Software Solutions (TAAS) works on the principals of Multiple Intelligence's (MI) created by Harvard University and innovated by TAAS, MI has been successfully utilized across 21+ countries. TAAS is a patented platform that connects the uniqueness of every organization to a similarly unique talent pool 

 

FIT PRE-CERTIFY® is a scientifically created evaluation administered via Computer Based Testing (CBT) in a proctored environment across PAN India that creates a database of eligible candidates than can be accessed instantaneously 24 X 7. 

 

The Nursing FIT approach has gone through the process of understanding the competencies of a successful nurse and then creating a customized profile reflecting the attributes displayed by the successful Nurse. 

 

A good profile is then measured to create a benchmark SCORE called FIT (Focused Integrated Talent) which represents a unique integrated competency number. This FIT score or the Nursing FIT score represents a number against which all people could be measured.

 

Pilot study and reliability:

Reliability of the tool was assessed by administering it to faculty from nursing. It was suggested to avoid double negatives in a question and to ensure that instructions regarding the timing for each module are present at the start of the module. These suggestions were incorporated during the final study.

 

Data Collection process:

Initial discussion with TASS took place and the competencies and attributes to be assessed were finalised. A non disclosure agreement was signed and it was decided to conduct the test on 10 and 11^thAugust 2018. Consent for participation in the study was undertaken.

 

The students were divided in a batch of 15 to 20. There were two instructors who initially explained the purpose of the test. They were told to provide honest answers and emphasis was given to explain that the questions are personal and that there would not be a right or wrong answer. The students were told to clarify doubts if any during the exam.

 

The instructors ensured that they were present along with the students during the entire course of test. It was seen that the students do not interact with each other during the test. Each module for testing had different number of questions and timing. The entire duration of test was 90 minutes.

 

After completion of one batch, the next batch was taken. Care was taken to see that the students who had undertaken the test would not interact with the next batch of students. Total 4 batches were taken for data collection.

 

All Students were then put through the evaluation to measure their competencies against the benchmark. Gaps were identified for further implementation.

Significant Findings:

Table I Analysis of attributes of nurses                                    N=74

Attribute	Score below 50		Score of 51-70		Score of 71-80		Score of 81-100
	Very low		Low		Average		High
	F	%	F	%	F	%	F	%
Accountability	1	1.35	29	39.18	26	35.14	18	24.32
Adaptability	12	16.21	59	79.73	3	4.05	0	0
Collaboration	0	0	21	28.38	38	51.35	15	20.27
Emotional intelligence	5	6.76	56	75.68	12	16.22	1	1.35
Decision Making	0	0	7	9.46	33	44.59	34	45.95
Patient Focus	0	0	25	33.78	30	40.54	19	25.68
Quality Focus	0	0	41	55.41	25	33.78	8	10.81
Handling stress	55	74.32	17	22.97	1	1.35	1	1.35
Overall FIT Score	3	4.05	71	95.95	0	0	0	0

 

Table II Analysis of competencies of nurses              N=74

Competency	Very Low		Low		Average		High
	F	%	F	%	F	%	F	%
Maturity	2	2.7	28	37.84	42	56.76	2	2.7
Time Management	0	0	3	4.05	34	45.95	37	50
Flexibility	4	5.41	42	56.76	28	37.84	0	0
System Driven	1	1.35	50	67.57	23	31.08	0	0
Team Player	0	0	0	0	46	62.16	28	37.84
Interpersonal Relationship	0	0	6	8.10	20	27.03	48	64.86
Social warmth	1	1.35	26	35.14	44	59.46	3	4.05
Sensitivity	2	2.7	43	58.11	29	39.19	0	0
Decision Making	0	0	3	4.05	54	72.97	17	22.97
Customer Service	0	0	3	4.05	62	83.78	9	12.16
Self Control	0	0	14	18.92	49	66.22	11	14.86
Hygiene	0	0	2	2.7	43	58.11	29	39.19
Safety	0	0	18	24.32	51	68.92	5	6.76
Handling Tension	29	39.19	38	51.35	7	9.46	0	0

 

Figure: 1 Analysis of the gaps among the attributes of nurses.

 

Figure: 2 Analysis of the average competency score among the nurses.

 

LIMITATIONS OF THE STUDY:

1.     The results could be different if student is assessed in real patient scenario.

2.     The data gathered cannot be completely reliable due to subjectivity issues, language constraints and personal barriers.

 

SCOPE OF THE STUDY:

The current study would enable identification of FIT provided to the students. These could form a base for improving the curriculum and identifying the reforms required to improve the FIT score. It would also enable individual students to take steps for personal enrichment. The assessment of the students could also be used by the hospital authorities during recruitment.

 

RECOMMENDATIONS:

Major steps are required to enable the nurses to handle stress. The curriculum will need to impart actual practical that could empower the nurses to learn quality patient care. Soft skill training to develop empathy, become patient focused needs to be ingrained. Critical thinking ability through use of scenarios, assignments for analysing reports, exposure to intensive care areas for developing advanced thinking will minimize the gaps and improve the overall FIT score of the institute. Accountability could be improved by initiating handing and taking over right from first year, making students responsible for the care of patient and taking steps and actions against non accountable actions.

 

CONCLUSION:

To conclude, it is seen that the education provided has gaps. The education needs to take remedial measures to empower the nurses to develop attributes like accountability, emotional intelligence, decision making and patient focus. The competencies that require attention are: flexibility, system driven and sensitivity and handling stress and tensions.

 

REFERENCES:

1.      Adami M. F, Kiger A. A study of continuing Nurse education in malta: The importanee of national context. Nurse Edue today, Jan- uag. 2005, 25(1):78–84. http://dx.doi.org/10.1016/j.nedt.2004.08.004. [PubMed]

2.      Hadizadeh F, Firoozi M, Shamaeyan-Razavi N. Nursing and Midwifery students perspective on clinical education in Gonabad university of Medical sciences. Iranian Journal of Medical Education. 2005; 5(1):70–77.

3.      Martin, G., & Mitchell, G. (2001). A study of critical incident analy- sis as a route to the identification of change necessary in clinical practice: Addressing the theory-practice gap. Nurse Education In Practice, 1(1), 27—34. Retrieved August 5, 2006 from ScienceDi- rect database.

 

 

 

 

 

Received on 09.04.2019           Modified on 07.05.2019

Accepted on 01.06.2019          © A&V Publications all right reserved