Journal of Nursing Education

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Self-Actualization and Professional Socialization of Nursing Students in the Clinical Laboratory Experience

Patricia Holleran Cotanch, RN, PhD

Abstract

Introduction

Nurse educators agree that nursing students need a clinical laboratory experience as part of the students' basic nursing education preparation. It is within the clinical laboratory (field) experience that the prospective professional can try out a good deal of what has so far only been theorized in the educational program. In nursing, as in other professional occupations such as law, social work, or medicine, it is necessary for the student to learn the culture of that occupation. This learning process is termed professional socialization. Central to the investigation in this area has been the question of how a person entering a professional program develops from the level of an initiate to the level of being a professional.

Professional socialization involves more than just a mastery of selected skills. An important aspect of the education of the professional nurse is to prepare the individuai to deal with matters in our society that are urgent and significant to people. Successful professional education prepares the individual to deal with one or more of these people problems by providing one or more of the specialized services to society. Combs' states that the professional helper of today, who deals with human problems uses himself, his knowledge, his skills, and the necessary available resources to solve the problems for which he is responsible. McGlothlin2 states that students in a professioanl program must bring together knowledge and skills into a repertoire of effective procedures that can be recalled when necessary in order to effectively solve the problems that they are likely to encounter in their profession.

Conclusion

The results of this study supported one of the basic hypotheses. It appears that a change in self confidence, self-acceptance, and self -actualization is part of professional socialization which is likely to occur as students become familiar with the expectations demanded by their profession. Personality changes of beginning and senior students have been supported by other studies.4-6,12,15-17

Junior and senior nursing students evaluated their instructors similarly. It appears that the changes in levels of self-actualization (as measured by the POI) do not effect how the students evaluate their instructors. It seems that the internal changes within the students do not alter how they feel about the instructor/student relationship. It would be interesting to see if the students' internal changes did alter how they felt about nursing, other health care personnel, and clinical laboratory sites. These comparisons were not attempted in this study.

Senior students were more likely to receive higher final grades from their instructors than junior students received from junior instructors. Other studies show that students with self-actualizing levels are more successful in clinical nursing.4,18 Reasons were stated as to the outcome of this result.

Finally, instructors of juniors had higher mean scores on certain POI subscales than did instructors of seniors. Reasons for this result were discussed. It is thought that the lower POI subscale scores of instructors of seniors may be reflecting the less accepting attitudes the senior students have toward nursing personnel they encounter, including their instructors.

Recommendations

Based on the dated findings the following is recommended.

1. Further studies are needed to test this study's gene rali zability to other populations of nursing instructors and students. It may be interesting to see if similar changes in levels of self -actualization exist when schools are studied from other geographical locations with different academic conditions such as traditional versus non-traditional curricula.

2. It is suggested that a replication of the study be performed at schools of nursing that have a three or four year time period involving a clinical laboratory experience. This way a longitudinal study…

Introduction

Nurse educators agree that nursing students need a clinical laboratory experience as part of the students' basic nursing education preparation. It is within the clinical laboratory (field) experience that the prospective professional can try out a good deal of what has so far only been theorized in the educational program. In nursing, as in other professional occupations such as law, social work, or medicine, it is necessary for the student to learn the culture of that occupation. This learning process is termed professional socialization. Central to the investigation in this area has been the question of how a person entering a professional program develops from the level of an initiate to the level of being a professional.

Professional socialization involves more than just a mastery of selected skills. An important aspect of the education of the professional nurse is to prepare the individuai to deal with matters in our society that are urgent and significant to people. Successful professional education prepares the individual to deal with one or more of these people problems by providing one or more of the specialized services to society. Combs' states that the professional helper of today, who deals with human problems uses himself, his knowledge, his skills, and the necessary available resources to solve the problems for which he is responsible. McGlothlin2 states that students in a professioanl program must bring together knowledge and skills into a repertoire of effective procedures that can be recalled when necessary in order to effectively solve the problems that they are likely to encounter in their profession.

The clinical laboratory has been the place where the students are provided with the opportunity to accomplish the integration of theoretical facts and professional applications.1 In the nursing clinical laboratory, the students work with and under the direction of clinical nursing instructors. Nursing instructors are expected to be experienced, successful, master practitioners of nursing. It is through this relationship between student and instructor that nursing students develop skills, techniques and interpersonal capabilities necessary for successful professional clinical nursing.

In attaining professional socialization, the students must abandon lay views of nursing and begin ascribing to those views accepted by the profession. In doing this it is necessary to deal with feelings of interpersonal incompotencies before one can attempt to successfully develop a nursing identity.4

Prior Research

A great deal of research has been published in the area of professional socialization. However, since this current study was conducted using baccalaureate nursing programs, the research review in this paper is limited to studies focusing on collegiate nursing programs.

Olsen and Whittaker5 published their findings from a major project on nursing students' professional socialization process. They discuss the phenomenon of "studentpersonship." This is described as the processes by which the students psych out the program, and assumes a set of acceptable behaviors which will help the students successfully go through the nursing program. They felt that such behavioral adaptation was necessary to the process of socialization. These behaviors made the students more aware of their abilities about perceiving interpersonal relationships from a professional framework. It allowed the student to "become" by assuming the required level of socialization before integrating it. Olsen and Whittaker discuss the cyclic feelings the students frequently encountered. They state it was easy to understand the depression and selfdeprecation students experienced when the students realized that nursing was infinitely more complica ted and psychologically more draining than they initially believed. Working through these feelings eventually gave nurses a revised image of nursing.

Davis and Olsen6 published an article based on the same research. They identified three major identity stresses that the nursing students were likely to encounter while acquiring professional socialization. The first stress was of a social nature that occurred when the nursing students had to deal with the professional boundaries set up by the male medical students. The second identity stress occurred when nursing students moved to a milieu which was almost completely populated by females. Davis and Olsen believed that because of the high concentration of females in the environment, the students elected to choose social interaction behaviors that enable them to get along well with females, concentration of females in the environment, the students elected to choose social interaction behaviors that enable them to get along well with females.

It must be kept in mind that this major study was done in the early sixties. This was before the advent of the Women's Liberation Movement. More recently published articles7'9 offer substantive assistance to nursing faculty members who are aware of feminist issues facing nursing but are not sure how to implement their ideas into classroom and clinical teaching.

The third source of identity stress comes from the students' realizing the responsibility that is required from them while functioning in clinical laboratory experience.

The Davis and Olsen study was replicated in 1974 by Brown, Braders, and Oberman.10 Similar results were found and they reported that the socialization process is loaded with inner conflicts and ambivalence that possibly plague nurses years after formal education has been completed.

Davis coined the phrase of doctorinal conversion to describe the psychosocial process whereby students exchanged their own lay views and imagery of nursing for those more accepted by the profession. In attaining the stable stage of doctorinal conversion the student used professional rhetoric and identified positive and negative role models of professional nursing. Clinical instructors were seen, as positive role models and staff nurses were seen as negative role models.

Quint11 states that the nursing model of therapeutic agent that exists between instructor-student-patient is often a theoretical rather than an actual model. It is prescribed but seldom demonstrated by the instructor.

Kramer et al.4 published an article on student achievement and socialization. They suggested if the nursing faculty are to meet students' requirements for effective professional socialization, there should be a link between the content the faculty teaches and their own nursing activities. The role learned by students in nursing schools reflects the faculty's ideal image rather than realistic image of nursing. Consequently, when students enter employment as graduate nurses, they are faced with a socialization adjustment which is less than functional and affects their preference for nursing practice. Kramer ~ states it is the idealistic educational orientation to nurse versus the realistic nursing service orientation that is the major cause of "reality shock" for the new graduate.

In another article, Kramer, McDonnell, and Reed13 suggested that the self-actualizing values for which students enter nursing should be reinforced by faculty and nursing service. It is the strong self-concept of the high self-actualizing student that enables him/her to adapt more readily to the role of professional nursing. For proper socialization to occur a positive relationship must exist between faculty and hospital nursing personnel and nursing students.

Another investigation was performed by Tetreault14 in a baccalaureate nursing program to see what institutional and demographic factors in the program might influence students' acceptance of professional beliefs. Her conceptual framework for the study was based on the belief that for an instructional situation to be conducive to students' acceptance of professional beliefs, the message, the teacher, and the student components should be characterized so that the sudents can perceive them as having cognitive consistency. The results show that the student demographic data was not significant. Only teacher professional attitude and class status rendered results noteworthy of prediction. As far as professional message was concerned the findings implied that teachers might bring about even higher professional attitudes if more of them displayed high positions on professionalism. For teacher characteristics, students' professional attitude was positively related to teacher credibility. Students felt learning was enhanced when they could trust their teachers and saw them behaving in a professional manner with the students and others (clients and other health care personnel). For class status, the juniors seemed to be unaffected by teacher structuring. The seniors were more sensitive to teacher leader behavior than the juniors were. This implies that seniors were ready to accept less teacher structuring as a reward for professional behavior. Tetreault recommends that a stronger teacher position on the professional message, coupled with increased teacherconsideration for all students, and decreased teacher structuring for seniors should be encouraged in nursing1 schools to assist the students' professional socialization.

Gunter15 reported that sophomore level students were more sympathetic than senior level students. Smith16 stated that as nurses mature in the profession, they tend to become stricter, more detached, and harsh.

Smith17 states that it is very possible that the disenchantment of nursing by nurses may not be from the nursing profession per se. The blame belongs in theinitial teachinglearning process the students encounter while in formal nursing education programs.

Finally, Sobol18 conducted a study where she investigated the relationship between self-actualization and the nursing students' response to stress. She found the level of self-actualization (using the POI) varied inversely with the level of trait anxiety (as measured by Spielberger's State-Trait Anxiety Inventory). The results also showed that variability in self -actualiza tion contributes significantly to variability in state anxiety under stress conditions. Consequently, students with higher levels of self -actualization were better able to develop and maintain the necessary professional skill and values.

To date there is little empirical data that attempts to quantify/qualify the change in "self" that the student undergoes while attaining professional socialization. With better recognition of personality changes students and faculty can have more insight and awareness into the professional socialization process. This will hopefully further the growth and learning of nursing students and clinical faculty specifically in the area of clinical experience and professional socialization.

Conceptual Framework

Nursing is an art as well as a science, and as such its strengths lie in the strength of the successful professional socialization of the individual nurse. According to May19 the capacity to create ourselves is inseparable from consciousness or self-awareness. Without self-awareness, the nurse remains controlled by inhibitions, repressions and childhood conditionings. Changing one's lay views and ascribing to those of the profession is an essential aspect of professional socialization. Increased understanding of one's personal development promotes the development of helping relationships that are intrinsic to professional helper's practices.20 By investigating the mechanism of change the nursing students encounter while attaining professional socialization, nurse educators can gain insight and help future students facilitate the change process. To investigate if a change in personal levels of self -actualization was associated with the professional socialization process the following hypotheses are stated:

1. Junior students will score higher on the total POI and subscale scores than seniors.

2. Junior nursing students would evaluate their clinical instructors higher (using the clinical Student Perception Questionnaire) than senior nursing students.

3. There would be no difference in the clinical grades of junior and senior nursing students.

4. There will be no difference in the POI scores of instructors of juniors and instructors of seniors.

Investigational Procedure

The total possible population of junior and senior students enrolled in clinical courses at the two selected southeastern universities was 498. The total number of clinical groups was 57 with one instructor per clinical group. All clinical instructors and nursing students were contacted personally. The purpose of the study was explained and their participation was requested.

The final sample used in this study consisted of 48 clinical groups consisting of 48 instructors and 280 students. This included 24 instructors of juniors and 142 junior students;and 24 instructors of seniors and 138 senior students. All participants were in the fall term clinical nursing course of their respective universities. The clinical nursing courses at both universities were similar in structure and content. Both universities had upper division nursing programs with clinical courses being started in the junior year.

The measuring instruments used were Shostrom's Personal Orientation Inventory (POI) and the Clinical Student Perception Questionnaire (CSPQ).

The POI was constructed by Everett Shostrom in 1964. 2I He consulted with Abraham Maslow as to the construction of this personality measurement instrument because the POI is conceptually related to Maslow's writings on self -actualiza ton and humanistic psychology.22 The POI consists of 150 items of the two force choice comparative values and behavior judgments that are negatively and positively stated. It is divided into two major parts. One part, which consists of 127 items, is the Inner Directed support scale that measures whether an individual's manner of interaction is typically "self" oriented (guided by internal principles) or "other" oriented (guided by peer groups or external forces). Part two consists of the Time Competence/Incompetence scale. The scale measures the degree to which a person has a present orientation as compared to past or future orientation. The two parts are further divided into 10 subscales. Scores on each subscale reflect an important factor necessary in the development of the selfactualizing person. The POI has been standardized by establishing norms on people from the general population and from many different occupational and professional groups. Standardizations ha ve also been done on people in the helping professions including the nursing profession.

The Clinical Student Perception Questionnaire (CSPQ) was an investigator made tool which closely relates the response items on the CSPQ to the actual language and variables used in the POI. Construct, content, face validity, and reliability were established for the CSPQ.

The Design of the Study

The data collection for the study included the following:

1. POI scores of the clinical nursing instructors for both levels of students.

2. POI scores of the junior and senior clinical nursing students.

3. Data concerning the nursing students' perception of their relationship with their nursing instructors obtained from the responses on the CSPQ.

4. Final grade of the clinical nursing students.

The t-test was used to compute the differences between the means for the various groups. These included junior and senior students' POI total scores and subscale scores and responses to the CSPO; instructors of juniors and instructors of seniors total POI and subscale scores and final grade of their clinical students.

The significant level for accepting the hypotheses was set at the .10 level. It was felt that this level was significantly stringent for an exploratory investigation of this type. A tighter significant level (.05 for example) may have increased the chances of making a Type I error in this type of investigation.23 It is believed that findings at the .10 level and beyond would be of interest to nurse educators concerning the changes in levels of self -actualization and professional socialization of students.

Results and Discussion

When comparing the mean total POI and subscale scores of junior and senior nursing students, the junior students scored higher on almost all subscales and significantly higher on four subscales. The results, shown in Table I, will now be discussed.

The Self-Actualizing Value subscale measures the degree to which an individual lives by Maslow's self -actualizing concepts. It consists of 26 items on the POI. Maslow describes the self-actualizing person as realistically oriented, spontaneous, autonomous, independent, creative, resistive of conformity, accepting the self and of the world. The self -actualizing person tends to be problem centered and has a desire to help the human race. He/She has a fresh, pleasurable appreciation of nature and people.22 Examples of Self -Actualizing Value subscale items include:

Table

TABLE 1T-TEST OF JUNIOR AND SENIOR LEVEL STUDENT MEANS ON THE P01 AND SUBSCALE MEASURES

TABLE 1

T-TEST OF JUNIOR AND SENIOR LEVEL STUDENT MEANS ON THE P01 AND SUBSCALE MEASURES

Item number 10: I live by values which are primarily based on my own feelings.

Item number 114: I have had an experience where life seemed just perfect.

Item number 146: I can like people without having to approve of them.

The second subscale that juniors scored higher than seniors was Existentiality. This subscale complements the Self-Actualizing Value subscale. It measures one's flexibility in applying values to one's life. It also measures a person's ability to use good judgment in applying general principles in life. People who score high on this scale reflect flexibility in application of values.21

The subscale consists of 32 items, examples of which are:

Item 2: I do not feel that I must strive for perfection in everything that I undertake.

Item 9: I do not feel I have a right to expect others to do what I want of them.

Item 67: I need not always assume responsibility for other people's feelings.

The Self-Acceptance subscale measures the person's ability to have affirmation of acceptance of self in spite of his/her weaknesses or deficiencies. A low score on this scale indicates a person's inability to accept personal weakness or deficiencies.21 The Self-Acceptance scale consists of 27 items on the POI. Examples of SelfAcceptance items are:

Item number 28: "My feelings of selfworth do not depend on how much I accomplish."

Item number 37: "I feel that I have rejected many of the moral values I was taught."

Item number 72: "I accept inconsistencies within myself."

The final subscale analysis that yielded significant results was Acceptance of Aggression. This scale measures the ability of a person to accept anger or aggression within one's self as being a natural feeling. A person who scores low on this scale denies having angry or aggressive feelings.21 The Acceptance of Aggression scale consists of twenty-five items, examples of which are:

Item number 131: "Sometimes I feel so angry I want to destroy or hurt others."

Item number 135: "I find some people who are stupid and uninteresting."

Item number 133: "I like to withdraw temporarily from people."

In looking at the results of how students evaluated their instructor no significant difference was found (Table 2). However, instructors of seniors evaluated senior students higher than the instructors of juniors evaluated juniors (Table 3). Even though senior students received a higher mean final grade, it was the junior level instructors and students who scored higher on the POI and subscale scores. One can only speculate as to why seniors receive higher grades than junior students because there are no published studies which address this difference in grading. Some possibility for the difference in grading seniors may be due to the fact that there is greater attrition in the junior year so that seniors are a more select group. Another possible reason may be that seniors have learned what is required by the educational system and are therefore better able to achieve clinical course objectives. Finally, the difference in grading may be the result of the instructors being more willing to give seniors the "benefit of the doubt."

Table

TABLE 2T-TEST OF THE MEANS OF CSPQ FOR JUNIOR AND SENIOR LEVEL STUDENTS

TABLE 2

T-TEST OF THE MEANS OF CSPQ FOR JUNIOR AND SENIOR LEVEL STUDENTS

Table

TABLE 3T-TEST OF THE MEANS OF FINAL GRADES GIVEN BY INSTRUCTORS OF JUNIORS AND INSTRUCTORS OF SENIORS

TABLE 3

T-TEST OF THE MEANS OF FINAL GRADES GIVEN BY INSTRUCTORS OF JUNIORS AND INSTRUCTORS OF SENIORS

The results shown in Table 4 show the significant differences that were obtained when comparing the means of the POI and subscale scores of the two levels of instructors. Significant differences were obtained on the Self -Actualizing Value, Self-Regard, Self-Acceptance and Synergy subscales.

The Self-Regard subscale measures a person's ability to like him/herself as an individual because of a high degree of inner strength. A low Self-Regard subscale reflects a person who has a low self worth. Instructors of junior students scored higher on the scale than the instructors of seniors. No studies are reported in the literature that investigated the type of instructor who is likely to teach senior students. While there is no empirical investigation on the type of instructor, it is generally believed among nurse educators that higher nurturing instructors prefer the beginning level student.

It is possible that the instructors of juniors a re responding to the positive attitude that junior students are more likely to have toward nursing. Juniors are more willing to accept information and do what is asked of them. Seniors, in contrast, are more likely to question their own personal feelings and opinions of their instructors and other health team members. The low Self-Regard scale obtained by instructors of seniors may be reflecting the less accepting attitude the senior students are more likely to have toward nursing and the professional people they encounter.

On the Self-Actualizing Value subscale, instructors of juniors again scored higher than instructors of seniors. The SeIfActualizing Value subscale measured the degree to which a person lives by Maslow's concepts of self-actualization. The lower Self-Actualizing scores for instructors of seniors may reflect the more trying instructor/student interaction that is likely to occur during the senior year in collegiate nursing programs. Tetreault14 reports that junior students are unaffected by teacher structuring. Senior students were more sensitive to instructor leader behaviors and were ready to accept less structure from nursing instructors. It is likely that the Self-Actualizing Value scores of instructors of seniors is reflecting an instructor/ student interaction where the Studentsare desiring more independence and the instructors are not allowing more independence.

The directions for completing the POI state that the participant is to read each item and decide which of the two paired statements most consistently applies to his/her life in general. It is possible that the participants (especially the instructors) responded to the POI items keeping in mind a student/instructor relationship rather than life relationships in general. Possibly, the investigator instilled the student/instructor mind set while explaining the purpose of the study. Also, the investigator, being a nurse educator, could have elicited identification from the instructors which would not have occurred had a non-nurse educator been data collecting.

Table

TABLE 4T-TEST OF INSTRUCTORS OF JUNIORS AND INSTRUCTORS OF SENIORS MEANS ON THE P01 AND SUBSCALE SCORES

TABLE 4

T-TEST OF INSTRUCTORS OF JUNIORS AND INSTRUCTORS OF SENIORS MEANS ON THE P01 AND SUBSCALE SCORES

Conclusion

The results of this study supported one of the basic hypotheses. It appears that a change in self confidence, self-acceptance, and self -actualization is part of professional socialization which is likely to occur as students become familiar with the expectations demanded by their profession. Personality changes of beginning and senior students have been supported by other studies.4-6,12,15-17

Junior and senior nursing students evaluated their instructors similarly. It appears that the changes in levels of self-actualization (as measured by the POI) do not effect how the students evaluate their instructors. It seems that the internal changes within the students do not alter how they feel about the instructor/student relationship. It would be interesting to see if the students' internal changes did alter how they felt about nursing, other health care personnel, and clinical laboratory sites. These comparisons were not attempted in this study.

Senior students were more likely to receive higher final grades from their instructors than junior students received from junior instructors. Other studies show that students with self-actualizing levels are more successful in clinical nursing.4,18 Reasons were stated as to the outcome of this result.

Finally, instructors of juniors had higher mean scores on certain POI subscales than did instructors of seniors. Reasons for this result were discussed. It is thought that the lower POI subscale scores of instructors of seniors may be reflecting the less accepting attitudes the senior students have toward nursing personnel they encounter, including their instructors.

Recommendations

Based on the dated findings the following is recommended.

1. Further studies are needed to test this study's gene rali zability to other populations of nursing instructors and students. It may be interesting to see if similar changes in levels of self -actualization exist when schools are studied from other geographical locations with different academic conditions such as traditional versus non-traditional curricula.

2. It is suggested that a replication of the study be performed at schools of nursing that have a three or four year time period involving a clinical laboratory experience. This way a longitudinal study could be performed to see if a pattern exists concerning changes in self-actualization of students and instructors.

3. It is recommended that future studies be conducted that investigate the effect of the administration's expectations of the relationships to faculty and students regarding the professional socialization process.

Information from the suggested studies may prove useful in revising recruitment procedures and selection criteria of students. Such information should be shared with prospective students so they can be aware of the responsibilities the profession requires from them. This can improve the chances that the selected applicants will be able to develop and successfully maintain skills and values required by the nursing profession.

The recommended studies will also add insight into the characteristics of faculty in schools of nursing and the conditions in which they are teaching. This will encourage administration in schools of nursing to introspectively investigate the milieu in which the students' professional socialization is occurring. Many schools of nursing continue to be influenced by structured, autocratic administration which is a remnant of the era when nursing schools were rigid and traditional. It is almost impossible for faculty to develop the needed professional qualities of autonomy, self-realization and self-direction in such a setting. If faculty are not able to operate under these self-developing principles it is ludicrous to expect students to achieve these desired personal and professional goals.

Fortunately, the nursing profession is influenced by the current social climate that encourages women to be more assertive, to participate in more open, direct communication, to take risks and handle more responsibility. Further studies about the process of the professional socialization of students/instructors/administration may render results which will add to the nursing knowledge base. This knowledge base could then be considered in making organization plans and curriculum design. The obtained informed could also be used in faculty recruitment and student selection. The overall outcome will result in the education of the kind of nurse who is able to successfully carry out his/her professional responsibilities in meeting societal health care needs.

References

  • 1. Combs A: The Professional Education of Teachers. Boston, Allyn and Bacon Inc., 1965.
  • 2. McGothlin W: The Profess tonal Schools. New York, Center for Applied Research in Education, 1964.
  • 3. Infante M: The Clinical Laboratory in Nursing Education. New York, John Wileyand Sons, 1975.
  • 4. Kramer M, Hinshaw A, Patterson R, Taylor M: Effects of teacher and situational variables on student achievement. Nurs Res 17:10-8, 1968.
  • 5. Olsen V, Whittaker E: TAc Silent Dialogue: Study in Social Psychology of Professional Socialization. San Francisco, Jossey Bass, 1968.
  • 6. Davis F, Olsen V: Initiation into a women's profession in the status transition of coed to student nurse. In F. Davis (ed) illness, interaction and the Self. Belmont, Calif. Wadsworth Publishing, 1972.
  • 7. Madden B: Raising the consciousness of nursing students. Nurs Outlook 23: 293-296, 1975.
  • 8. Krilek P, Class L:Nursing: A feminist perspective. Nun Outlook 26: 182-186, 1978.
  • 9. deTornyay R: Changing student relationships, roles, and responsibilities. Nurs Outlook 25: 188189, 1977.
  • 10. Brown J, Bidders Y, Oberman M: Baccalaureate students' images of nursing: A replication. Nurs Res 23: 53-59, 1974.
  • 11. Quint J: Role models and the professional nurse identity. J Nurs Educ 6: 11-16, 1967.
  • 12. Kramer M: Realilu Shock. St. Louis, CV Mosby Co, 1974.
  • 13. Kramer M, McDonneI! C, Reed J: Self actualization and role adaptation of baccalaureate degree nurse. Nun Res 21: 111-123, 1972.
  • 14. Tetreault A: Selected factors associated with professional attitudes of baccalaureate nursing students. Nun Res 25: 49-53, 1976.
  • 15. Gunter L: The developing nursing student. Nurs Res 18: 237-243, 1969.
  • 16. Smith J: Personality structure in beginning nursing students: A factor analytic study. Nurs Res 17: 140-145, 1968.
  • 17. Smith D: The effects of values on clinical teaching. In J. Williamson (ed.) Current Perspectives in Nursing Research, St. Louis, CV Mosby Co, 1976.
  • 18. Sobol E: Self-actualization and the baccalaureate nursing students' response to stress. Nurs Res 27:235-244, 1978.
  • 19. May R: TAc Courage ?a Create. New York, WW Norton and Co, 1975.
  • 20. Combs A, Avila D, Purkey W-. Helping Relationships: Basic Concepts for the Helping Professions,. Boston, Allyn and Bacon, 1971.
  • 21. Shostrom E: Manual for the Personal Orientation Inventory. San Diego, Educational and Industrial Testing Service, 1974.
  • 22. Maslow A: Motivation and Personality. New York, Harper Publishing Co, 1954.
  • 23. Kleinbaum D, Kupper L: Regression Analysis ami Multivariate Methods. North Scituare, Mass. Duxbury, Col, 1978.

TABLE 1

T-TEST OF JUNIOR AND SENIOR LEVEL STUDENT MEANS ON THE P01 AND SUBSCALE MEASURES

TABLE 2

T-TEST OF THE MEANS OF CSPQ FOR JUNIOR AND SENIOR LEVEL STUDENTS

TABLE 3

T-TEST OF THE MEANS OF FINAL GRADES GIVEN BY INSTRUCTORS OF JUNIORS AND INSTRUCTORS OF SENIORS

TABLE 4

T-TEST OF INSTRUCTORS OF JUNIORS AND INSTRUCTORS OF SENIORS MEANS ON THE P01 AND SUBSCALE SCORES

10.3928/0148-4834-19811001-03

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