Journal of Nursing Education

A Review and Synthesis of the Research on Role Conflict and Its Impact on Nurses Involved in Faculty Practice Programs

Clinton E Lambert, Jr, MSN, RN, CS; Vickie A Lambert, DNSc, RN

Abstract

ABSTRACT

A review of the literature is presented that offers an overview of state-of-the-art research on role conflict and its impact on nurses involved in faculty practice programs. The literature is described in terms of: 1) where the research has been reported; 2) who the researchers have been and from what discipline they have come; 3) the major theoretical perspectives used; 4) the unit of analysis studied; and 5) the research methods used.

Abstract

ABSTRACT

A review of the literature is presented that offers an overview of state-of-the-art research on role conflict and its impact on nurses involved in faculty practice programs. The literature is described in terms of: 1) where the research has been reported; 2) who the researchers have been and from what discipline they have come; 3) the major theoretical perspectives used; 4) the unit of analysis studied; and 5) the research methods used.

Introduction

Sociologists were the originators of research on and about role conflict in the 1940s. Role conflict was first measured in conjunction with role ambiguity. Groups and organizations, as well as individuals, were analyzed after a role questionnaire, which measured both role conflict and role ambiguity, was developed in 1970.

Nurses became interested in the study of role conflict when it became evident that the hospital nurse, in the late 1970s, was experiencing role dissatisfaction. The push to get the nurse academician back into the practice arena brought to light the potential for and existence of role conflict among and within nursing faculty. Role conflict and its impact on nurses involved in faculty practice programs is an area which has been recognized, especially in terms of time not being allocated for faculty to practice, but which has not been thoroughly researched.

Academicians and practitioners are in jeopardy of experiencing role conflict if they attempt to merge practice with academe. Although academicians within nursing have decided that now is the time for nurse educators to practice (Mauksch, 1980), the merging of clinical practice with academic expectations has created dilemmas for both the individual and the institution (Millonig, 1986). Nurses have experienced the incompatibility of attitudes and behaviors that comes from being devoted to teaching while also being committed to practice, and trying to merge the two. Thus role conflict has emerged as an organizational problem for the institutions of higher learning within nursing.

Recognizing that nurses involved in faculty practice will continue to experience role conflict until effective alternatives are found, this article will address role conflict and its relevance to nurses involved in faculty practice programs within nursing.

Role Conflict

Samuel Stouffer, a sociologist, reported an empirical procedure for studying role obligations with particular reference to "simultaneous role obligations with conflict." Stouffer's three propositions included:

1) In any social group there exist norms and a strain for conformity to these norms; 2) Ordinarily, if the norms are clear and unambiguous the individual has no choice but to conform or take the consequences in group resentment; and 3) If a person has simultaneous roles in two or more groups such that simultaneous conformity to the norms of each of the groups is incompatible, he can take one of only a limited number of actions, for example: 1) He can conform to one set of role expectations and take the consequences of non-conformity to other sets, or 2) He can seek a compromise position by which he attempts to conform in part, though not wholly, to one or more sets of role expectations, in the hope that the sanctions applied will be minimal (Stouffer, 1949, p. 707).

This theory provided the foundation of the framework for the research on role conflict which has followed by building upon the proposition of Cottrell (1942) regarding the social roles one performs. Stouffer (1949) loosely defined role conflict as "strains to conformity to norms incompatible from one group to another" (p. 708). Using an empirical study of conflicting role expectations (by way of questionnaire and using the individual as the unit of analysis), he identified three main types of responses to role conflict based on how the subjects perceived the role conflict.

In defining a role as "an internally consistent series of conditioned responses by one member of a social situation which represents the stimulus pattern for a similarly internally consistent series of conditioned responses of the other(s) in that situation" fp. 617), Cottrell (1942), a sociologist, assumed that one's adjustment to a role could be measured. However, it was not until: 1) Parsons (1951) and Parsons and Shils (1951) recognized that roles allow for variability so as to enable those with different personalities to enact the same role, 2) Killian (1952) demonstrated that the merging of roles infringes on performance and is often the source of role conflict., and 3) Toby (1952) espoused that individuals do find themselves in situations where two or more groups make incompatible demands upon them, that research measures of role conflict were conducted.

While exploring operational procedures for linking the study of social norms with the study of personality, Stouffer and Toby (1951) recognized that role conflict between one's obligations of friendship and one's obligations to society was especially common among the 648 undergraduate students at Harvard and Radcliffe in 1950, to whom they had administered a questionnaire based on hypothetical situations. Such role-role and self-role conflicts, as pointed out by Sarbin and Alien (1954), are likely to follow from ambiguous role expectations with the persisting need for solution of these conflicts often leading to socially invalid role enactment. It was not until the work of Getzels and Guba (1954), however, that a method for investigating role conflict in a real life setting was tested.

Getzels and Guba (1954) determined the conflict between the roles of an officer and a teacher in a military situation when held by a single individual. They also determined the consequences of the conflict for effective management of one of the roles. They recognized that role conflicts ensued whenever an individual was required to fill two or more roles, the expectations of which were inconsistent in some particular way. Their unit of analysis was the individual officer-instructors and they recognized that each individual, in his respective role, was externally controlled by the military organization.

The findings of Getzels and Guba (1954) suggest that an individual typically seeks a role or creates one which permits the expression of his or her specific personality needs. They interpreted this finding to indicate that one most often chooses the role that is most compatible with one's needs when placed in a role conflict situation, and simply assimilates the other competing roles to it as the frame of reference. They also noted that if the role chosen by the individual in a role conflict situation was the legitimate role in the situation, the person was less likely to be affected by the conflicts or threats of sanctions experienced when choosing an alternate role. Their research set the stage for future studies both related to and about role conflict.

Sociologists have continued to investigate the source of psychological stress and social instability and have reported their propositions, theories, and findings in the various sociological journals. Goode (1960) introduced the term "role strain" to signify the difficulty of performing multiple roles. This led Sieber (1974) to later note that role strain comprises both role conflict and role overload. Sieber further defined role conflict as that which "refers to discrepant expectations irrespective of time pressures." Burr (1972), in an attempt to rework role theory to improve and extend the theoretical ideas, conceptually identified role conflict as the "presence of incompatible expectations of social role." Neither Goode, Sieber, nor Burr, however, reported their own research related to role conflict, although they did demonstrate that there are a number of ways of defining the term role conflict.

As behavioral psychologists (Kahn, Wolfe, Quinn, Snoek, Rosenthal, 1964; Katz & Kahn, 1979; Miles, 1976a, 1976b; Organ, 1971) and management analysts (Hamner & Tosi, 1974; Pondy, 1967) began conducting experimental studies within an organizational context, the focus of the research on role conflict turned to an exploration of the relationships of role conflict, role ambiguity, and worker attitudes and behavior. Through their studies, Kahn et al. (1964) became the recognized authorities on organizational stress and further operationalized role conflict. They identified role conflict as the situation in which one not only is required to play two or more roles that are in conflict with each other, but that the role that one is required to assume is in conflict with one's value system. Thus, role conflict was defined as the incongruity of expectations associated with a role, while role ambiguity, although not elaborately conceptualized, was seen as the experience of having to deal with single or multiple roles which have not been clearly articulated in terms of expected behavior or performance levels (Van Sell, Brief, & Schuler, 1981).

Role conflict and role ambiguity, although correlated, have been factorially identified as independent constructs (Rizzo, House, & Lirtzman, 1970). However, the preponderance of the organizational research examining role conflict also has measured role ambiguity. Even though role conflict has been detected and measured through use of a cumulative scale iGullahorn, 1956) and other perceptual instruments (Van Sell, et al., 1981), the predominant tool used to measure both role conflict and role ambiguity has been the self-report, 30-item role questionnaire developed by Rizzo et al. (1970). Their instrument was designed to measure one's perceived role conflict and role ambiguity and was initially tested on salaried managerial and technical employees (Rizzo, et al., 1970). The role questionnaire has been determined to be valid and reliable through psychometric evaluation across numerous samples (Van Sell, et al., 1981).

Various sociologists, psychologists, and management analysts have used the role questionnaire to investigate moderating effects of role ambiguity and role conflict on individual subjects in organizational settings. Such studies have involved examination of job involvement (Hamner & Tosi, 1974), job satisfaction (Johnson & Stinson, 1975; Keller, 1975), and personality-related values (Keller, 1975) in relation to the individual subject's experienced and perceived role conflict and role ambiguity. Van Sell et al. (1981) point out that the best documented outcomes regarding role conflict perceived by individuals are job dissatisfaction and job-related tension. This may explain Houses (1974) comments that there has been rather consistent evidence that role conflict, as a dimension of job pressure, significantly increases heart disease risk.

Even though most of the studies reviewed that have related to research on role conflict have used the individual subject as the unit of analysis, Miles (1976a, 1976b) and Miles and Perrault (1976) recognized that the relative strengths of relationships between role conflict, role ambiguity, and various organizational role perceptions have an outcome on groups of professionals as well as on the individual. In addition, through cross-sectional field studies of boundary- spanning requirements (Miles, 1976b; Leifer & Huber, 1977), an understanding of organizational correlates of role conflict has arisen.

It is recognized that organizational boundaries function to circumscribe or limit the organization since they control the flow of information between the organization and its environment (Leifer & Huber, 1977). Therefore, the conflicts which arise between professionals in bureaucratic organizations often result in job dissatisfaction and job migration (Sorensen & Sorensen, 1974). This may be significant to nurses in light of the remarks made by Hrebiniak and Alutto (1972), two organizational behavioralists, in a descriptive study of elementary and secondary school teachers and registered nurses. Hrebiniak and Alutto have reminded us that nurses have been identified as being bound in a doctor-nurse-patient triad with little professional discretion and self-regulation of their role activities. In addition, their findings are in agreement with those who have argued that a lack of tension and ambiguity in the performance of organizational roles could be properly regarded as an organizational asset.

Tosi and Tosi (1970), using.a shortened version of the role instrument developed by Rizzo and House in 1968, recognized that high levels of organization stress, defined in terms of role conflicts and role ambiguity, often result in low job satisfaction, low confidence in the organization, and a high degree of job-related tension among elementary and secondary school teachers. Simmons (1968), in an experimental study of 135 male undergraduates, recognized that in a complex organization, the first -line supervisor is the focus of much role conflict. These research reports of role conflict experienced by teachers and first-line supervisors have increased in significance to nurses when it is recognized that teachers' control over educational ends is delimited by local administrative hierarchies, state policies, and concerned communities or external pressure groups (Hrebiniak & Alutto, 1972). The behavior of first-line supervisors, however, is often controlled by the conflicting norms of the workers and management (Simmons, 1968). Nurses also are prone to experience similar lack of control over their practice and to be under the influence of a myriad of others.

Role Conflict in Nursing

Conway (1983) reminds us that "nurses have become interested in discovering the salient subjective and structural factors that may contribute to dissatisfaction with the role of hospital nurses" (p. 198). This desire for knowledge has led nurse researchers to spawn a small body of research focused on role stress, role strain, and role conflict. Hardy (1978) has pointed out that although role conflict, role ambiguity, role incongruity, and role overload all have been seen as components of role strain and as dimensions of the general concept of role stress, the terms have been used interchangeably in the reported nursing literature, depending on the various investigators' definitions of them.

Role theory development (Hardy & Conway, 1978; Meleis, 1975) has provided the framework for the investigation of role conflict in nursing. Through examination of the conception of the nursing role (Minehan, 1977; Dreesen Kinney, 1985), nurse researchers have been able to study how nurses in the practice setting and in academe have perceived their roles. Although there have been some surveys of the relationships between personal, job, and organizational factors and perceived role conflict between practicing nurses and physicians (Chacko & Wong, 1984), descriptive studies of the new graduate in the hospital setting have been the predominant type of research conducted in regards to role in the practice arena. Nurse researchers, through the use of descriptive studies and using the individual as the unit of analysis, have attempted to determine how the new graduate relates role conception to various personality variables (Dreessen Kinney, 1985) and behaviors (Ketefian, 1985) while experiencing a role demand which may be perceived as antithetical to the learned ideal role.

Nursing faculty, however, have been studied from how they spend their time (Solomons, Jordison, & Powell, 1980) to how they are viewed as instructors (Stuebbe, 1980; Brown, 1981). This is in light of the fact that nursing faculty have been credited with having greater difficulty than faculty from other disciplines in establishing and succeeding in an academic career in institutions of higher learning (Davis & Williams, 1985). The fact that teaching, research, service, publishing, practice, and study toward an advanced degree are expectations of the nursing faculty member has given rise to the investigation of role issues for the nurse educator (Charron, 1985). While there has been a long history of conflict between nurses in service and those in education, it has been only since the initiation of the collaboration model (Schlotfeldt & MacPhail, 1969a,b,cl and the unification models (Ford, 1981; Nayer, 1980; Sovie, 1981a,b) that studies, such as the survey by Chute and Oechsle (1986), have been conducted to investigate the perception of practicing nurses and educators.

Role conflicts have been identified as likely to arise for the nurse who has been socialized into the role of caregiver and then attempts to transit into the role of being a teacher in academe (Infante, 1986). Nurses in the survey Feldman (1976) conducted, testing his own model of socialization, scored higher on measures of conflicting demands and were less successful in resolving conflicting demands than other hospital employees. By recognizing that descriptive studies of faculty teaching in baccalaureate nursing programs have shown that nursing faculty are continually involved in conflict situations (O'Connor, 1978; O'Shea, 1982), and that nursing faculty most often resolve conflict by direct verbal confrontation (O'Shea, 1982), one is better able to understand the Stressors nursing faculty members experience (Hinds, Burgess, Leon, McCormick, & Svetich, 1985) and the consequences of unmet nursing faculty needs (Bauder, 1982). However, no distinct body of literature relates to the problem of role conflict within and among organizations as they undergo changes in relationships.

Nursing Faculty Practice

While the literature has described a variety of approaches for its development and implementation ( Diers, 1980; Archer & Fleshman, 1981; Dinsmore & Follow, 19811, nursing faculty practice has been recognized as "those functions performed by faculty within a service setting that have as their principal goal the continued advancement of the nursing care of patients/clients, a goal congruent with the role of an academician in a professional discipline" (Ford, 1983, p. 14). Since nursing faculty practice has been considered to be a link between nurses who have primary responsibility for education and those who have primary responsibility for client services, it has been touted as providing greater role satisfaction for all who practice nursing (American Association of Colleges of Nursing, 1979) and as a means to advance the discipline of nursing (Algase, 1986).

Unless the implications of nursing faculty practice on other components of nursing faculty roles are determined (Batey, 1983) (such as the amount of time which can be allocated for clinical practice), those nursing faculty who attempt to practice may experience role strain and role conflict (Wakefield-Fischer, 1983).

Although the literature contains numerous anecdotal reports about the various faculty practice programs in operation (Ryan & Barger- Lux, 1985), how nursing faculty have been mobilized to integrate practice into their faculty roles (Chickadonz, Bush, Korthuis, & Utz, 1981), and how to develop institutional practice plans for nursing faculty (Curran & Riley, 1984), there has been a scarcity of research on these topics.

The American Academy of Nursing, with partial funding from the Robert Wood Johnson Foundation, has held four annual symposia on nursing faculty practice in an attempt to bring structure to outcome (Barnard, 1983), to examine faculty practice in action (Barnard & Smith, 1985), and to assist in translating commitment to reality (Feetham & Malasanos, 1986).

Even though many presentations have been made at these symposia, the only research specifically related to nursing faculty practice which has been reported in their proceedings has been McClean's (1985) telephone survey. It reported how nine institutions designed compensation guidelines for faculty as roles combining teaching, practice, and research began to develop in the context of an organizational change.

McClean (1985) identified two common problems encountered by faculty in combined roles within the nine schools which responded. The suspicion of the respective nursing academicians and clinicians toward the nurse in a combined role reportedly made it difficult for the nurse in faculty practice to function comfortably in either setting. This problem was noted in conjunction with the lack of sufficient avenues for cooperation between education and service.

Respondents in McClean's (1985) survey did recognize the need for education and service to together define the academic and clinical expectations of the combined roles and how these expectations could be met best. McClean (1985 ) stated that, "failure to do this often puts the nurse in a combined role in an untenable position, and will certainly exacerbate the problem of suspicion and role conflict" (p. 180). However, research in the area of role conflict in nursing faculty practice continues to be sparse.

Nurse researchers have begun to conduct exploratory descriptive studies of nursing faculty practice and its potential for faculty role development (Porter, Counts, & Borgman, 1985), using individual faculty members as the unit of analysis, in an attempt to determine the relationship between nursing faculty work plan/school goal congruence, faculty productivity, potency, and job satisfaction.

As espoused by Fagin (1985), "Nurses who are excellent in practice need the same freedom to explore, to report their findings, and to speak out as do tenure-track standing faculty" (p. 13).

Anderson and Pierson (1983) recognized that the function of nursing faculty practice probably was not always incorporated with the role expectations and reward structures of universities' nursing faculty. They, therefore, conducted an exploratory study, using Sarbin and Alien's (1968) role theory as their framework, to ascertain the facilitating and/or inhibiting factors that individual nursing faculty members in all NLN-accredited baccalaureate programs perceived when trying to maintain their clinical skills (Anderson & Pierson, 1983).

Just as Batey (1983) had commented, Anderson and Pierson (1983) found that the majority of respondents involved in faculty practice were engaged in neither research nor professional writing and that the greatest inhibitor of nursing faculty practice was perceived workload. These findings may help explain the remarks which a clinician and an academician made regarding time being an undeniable barrier to practice (Morrison, 1985; Perry, 1985). On the other hand, one may have difficulty understanding that, although the faculty recognized administrative support to be the greatest facilitator of faculty practice and believed that the students reacted positively to their practice, faculty respondents in Anderson and Pierson's (1983) survey felt that moonlighting could accomplish their personal needs to practice.

Rosswurm (1981), in an attempt to understand how a nursing faculty as a group, involved in a faculty group nursing practice, combines teaching, practice, and research, surveyed the nursing practitioner programs listed in the 1979 publication, A Directory of Expanded Role Programs for Registered Nurses. She discovered that the two most common types of university appointments for the nursing faculty in the group practices were joint appointment and full-time appointment without specific time allocated for practice. This meant that many of the nursing faculty were forced to add practice hours onto a full-time teaching schedule. Due to the fact that only 23 group nursing practices responded to the questionnaire, Rosswurm was unable to make any generalizations or conclusions about which organization model worked best. She noted, however, that one of the greatest forces resisting promotion of faculty group nursing practice is time pressure.

Recognizing that too much role strain and role conflict can lead to distress or burnout not only to staff nurses, but also to nursing faculty, Dickens (1983) 1) reviewed the models for faculty practice which have been recognized, 2) determined evidence for mechanisms of social support which have been suggested for practicing nurses teaching in nursing programs, and 3) conducted a survey of nurse administrators for baccalaureate and higher degree nursing schools in the southeastern area states to discover what mechanisms of social support for nursing faculty were already in place to encourage faculty to practice. Ninetythree percent of the respondents indicated that there was no specified amount of time each faculty member was to devote to practice, while 94% responded that there was no specification of acceptable clinical practice activities that would meet the school's definition of clinical practice for full-time faculty.

This contrasted with 100% of the administration, according to Dickens (1983), who stated that they approved of faculty seeking to maintain clinical practice, while 68% indicated that they did not require that faculty practice, although some said they did encourage faculty practice. Dickens (1983) recognized that the most important reason faculty members should maintain practice activities to enhance their teaching roles is the support provided for career development and role transition.

Summary

Research which has been conducted and published related to and about role conflcit and nursing faculty practice has been reviewed and synthesized in this article. In reviewing the literature, it was noted that sociologists were the originators of research on and about role conflict in the 1940s and that their propositions, theories, definitions, and research findings were predominantly reported in sociological journals. They used the individual subject as their unit of analysis in their convenience samples of undergraduate college students.

Although theories of social norms and personality served as the early sociological theoretical perspectives for studies of role conflict, behavioral psychologists and management analysts began to use behavioral theory in an attempt to understand the relationship of role conflict to attitudes and behaviors and workers. The role questionnaire developed in 1970 facilitated examination of various moderating effects of role conflict and role ambiguity with a noted emphasis on job dissatisfaction and job-related tension. Studies of various professional groups and organizations were undertaken in the 1970s by organizational behavioralists, although undergraduate college students continued to be the predominant subject of the various descriptive surveys which were reported in a variety of sociological, psychological, and management journals.

As nursing role theorists developed and role theory evolved, nurse researchers began to conduct surveys of nurses both in academe and in practice using role theory as the major theoretical perspective from which to examine role expectations and conflicts. The preponderance of these descriptive studies were related to what was the new nursing graduate's role conception and were reported in Nursing Research.

An emphasis in the late 1970s within nursing schools to get the nursing academician back into the practice arena brought to light the potential for and existence of role conflict among and within nursing faculty. Although much discussion ensued about the topic of role conflict among nursing faculty, relatively few studies have been conducted related to the topic. With the development of nursing faculty practice programs, a few exploratory surveys began to appear in the early 1980s as to how those nurses who are involved in nursing faculty practice perceive their role and the role conflict they experience.

Descriptive, exploratory, self-report studies have dominated the research efforts of all who have investigated role conflict and its relationship to nursing faculty practice programs. The individual subject has been the predominant unit of analysis in the studies related to all aspects of role conflict. There have been an increasing number of studies which have used both groups and organizations as the unit of analysis in examining role conflicts over the last ten years.

It has been recognized that nursing faculty members must increase their commitment to and competence in practice and that clinicians must assume more responsibility in developing nursing knowledge and in the education of nurses. However, only studies related to the characteristics, views, social support, and compensation of nurses in nursing faculty practice were noted in the literature. Role conflict and its impact on nurses involved in nursing faculty practice programs is an area which has been recognized, especially in terms of time not being allocated for nursing faculty to practice, but which has not been thoroughly researched.

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