Nursing offers an individual a large variety of specialty areas in which to work, such as community health, intensive care, and mental health. Many student nurses are overwhelmed by the number of possibilities when searching for their first job. As professional occupational roles become more specialized, student nurses can be expected to experience even more specialty indecision (Savickas, Alexander, Osipow, & Wolf, 1985).
Registered nurses, 96% to 98% of whom are women (Muff, 1982), do not appear to plan sequential steps for a career path but instead make career moves when external factors confront them. The desire or need to care for their families and dissatisfactions found in their work environments, rather than careful career planning, are major determinants of when, where, and how often they participate in the nursing labor force (Cleveland, Bellinger, Shea, McLain, 1970; Gaertner, 1984; Knopf, 1983; Nolan, 1985).
Planning a career in nursing is important for the selfdevelopment of the individual nurse, as well as for the advancement of the nursing profession (Smith, 1982). Keough (1977) and Smith (1982) propose that the nurse can benefit from making conscious decisions about personal and professional goals, and from preparing for roles that motivate and fulfill personal aspirations. The nursing profession can benefit from nurses who carefully plan their careers; the image of nursing is strengthened by motivated practitioners who not only provide high quality service, but also view their careers as desirable and worthwhile.
Smith (1982) has suggested that career planning be started early in a nurse's career for optimal development. However, information on career planning is not commonly available to nurses. Kleinknecht and Hefferin (1986) have stated that "career-track thinking" is just now being introduced into some nursing schools. It seems essential to the nurse, and for the profession of nursing, to determine if career education will assist the nurse in career planning.
No research could be found investigating the career planning needs or the actual career planning of nursing students; however, many colleges and universities offer career planning programs to their students. Smith and Evans (1973) compared the effectiveness of a five-week vocational guidance program; individual counseling; and no treatment on the vocational development of 66 male and female freshman and sophomore university students. The vocational guidance program emerged as being more effective than the other treatment groups.
Bartsch and Hackett (1979) investigated the effectiveness of a for-credit, personal decision-making course on the locus of control, conceptualization, and career planning of 64 male and female undecided college students. The locus of control was altered toward a greater internality, career decision making concepts were learned, and significant increases in career planning were reached. Babcock and Kaufman (1976) compared a structured career planning course with individual counseling and no counseling as facilitators of career planning for 77 undergraduate college women. Findings revealed the career planning course was significantly more effective than the other treatment groups.
The literature suggests that a career planning course is effective in enhancing the career planning of college students in general, and that nursing students specifically appear to need career planning programs. Therefore, this study was designed to investigate whether subjects who participated in a career decision-making course would demonstrate a significantly higher level of career planning than would subjects who did not participate in the career decision-making course. Career planning was defined as recognition of the need for, and possibility of planning for, the immediate and more distant future (Super et al, 1982).
A total of 42 subjects (40 women and 2 men) between the ages of 20 and 55 were drawn from a population of final semester associate degree nursing students at a community college in southern California. The 42 subjects were randomly assigned to experimental and control conditions. The experimental group comprised 21 subjects, 20 of whom were women, with a mean age of 31. The no-treatment control group had 21 subjects, 20 of whom were women, with a mean age of 32. No significant differences were found between the two groups regarding demographic variables. Three subjects dropped out of the experimental group because of time constraints.
The Career Planning Scale (CPS) of the Career Planning Inventory - College and University Form (Super et al, 1982) consists of 20 self-report items that assess an individual's career attitudes and planning. The subject reports the nature and degree of career planning involvement and knowledge about the desired work. The scale is reliable, as evidenced by its stability (r = .89) and its internal consistency (coefficient a = .91). The construct validity is supported by the mean differences between year in college and scale scores (freshman, 97.1; sophomore, 98.2; junior, 109.2; senior, 108.5).
The Nursing Career Development Inventory (NCDI) (Savickas, 1984) is an adapted version of the Medical Career Development Inventory; the only modification is a change of certain words to make it specific to nursing. The NCDI is composed of 35 self-report items in a Likert-type format, which assess one's involvement in thinking about and planning a career. Reliability is supported by its internal consistency (coefficient a = .93). The validity is evidenced by appropriate judging of its content validity (Savickas, 1984), and the construct validity which is based on the mean differences between year in a BS/MD program and scale score (first year, 92.5; second year, 93.8; third year, 109.6).
Students were contacted during a nursing lecture. The nature of the study was described and assurances of anonymity and confidentiality were addressed. Volunteers stayed after class, reviewed and signed the informed consent sheet, and completed the demographic questionnaire, the CPS, and the NCDI. Subjects were then randomly assigned to experimental and control groups. The subjects in the experimental group were divided into three subgroups to enhance group discussion and accommodate the varied time schedules of the subjects.
The career decision-making course was based on a career counseling sequence recommended by Mitchell and Krumboltz (1984). The course consisted of a series of four structured classes that met once a week, two hours per day, for four weeks. Topics included self-assessment of values, interests and skills, occupational opportunities in nursing, and decision-making skills. In-class experience included lecture, written exercises, and group discussion. Outside assignments included interviewing a person in a desired nursing position.
After the subjects in the experimental group finished the course, all of the students were contacted after a nursing lecture for post-testing, or within the following week if absent. Arrangements were then made for the control group to attend the course.
The hypothesis that the subjects who participated in the career decision-making course would demonstrate a significantly higher level of career planning than those who did not participate in the course was tested and statistically supported. The one-way ANOVA on the change scores from pretest to post-test on the CPS data (F (1,37} = 11.41; ? = .002), and the NCDI data (F (1,37) = 23.75; ? < .00001), revealed significant differences between the groups. The mean pretest, post-test, and change scores, and standard deviations for the experimental and control groups on the CPS and the NCDI are listed in the Table. Nursing students obtained a mean pretest score of 60.1 on the CPS, compared with a mean score of 98.2 obtained by average college students.
MEANS AND STANDARD DEVIATIONS FOR THE PRETEST, POST-TEST, AND CHANGE SCORES ON THE CAREER PLANNING SCALE AND THE NCDI AS A FUNCTION OF TREATMENT GROUP
Intercorrelational data showed a high positive correlation between the CPS and the NCDI scores (r = .79; p < .0005 for post-test scores). Analysis correlating selected demographic characteristics such as work experience, licensure as a vocational nurse, and current employment with pretest and post-test CPS and NCDI scores showed a positive correlation for the amount of work experience in a nursing-related field (r = .43; p < .0005).
Multiple regression analysis was executed to determine the predictiveness of age; education of father, mother, and spouse; when the subject had decided to become a nurse; prior career counseling; and the amount of work experience in a nursing-related field on the CPS pretest, NCDI pretest, CPS change score, and the NCDI change score. Only the independent variable of work experience was found to be a predictor of prescores for the overall group on the CPS (t = 2.38; p = .02), and the NCDI (t = 3.89; p = .0005).
The structured career decision-making course emerged as an effective intervention for enhancing the career planning of associate degree nursing students. These findings are consistent with the research findings from Babcock and Kaufman (1976), Bartsch and Hackett (1979), and Smith and Evans (1973), whose studies support the effectiveness of structured decision-making courses as facilitators in the career needs of college students.
The mean CPS pretest score obtained by the overall group of nursing students was lower than that of the average college student. This finding is not surprising in light of the fact that women often have not planned their careers (Smith, 1982; Zunker, 1986). For example, Granrose (1985) investigated the career plans of college women through a mailed questionnaire and found that 64% had only general, simplistic, and short-term plans for managing their careers, whereas only 25% had a specific strategy. These findings emphasize the importance of providing structured career decision-making courses to nursing students, the majority of whom are women.
Further analysis correlating selected demographic characteristics with test scores showed a positive correlation for the amount of work experience in a nursing-related field with the pretest and post-test CPS and NCDI scores. These data indicate that the longer an individual is exposed to learning experiences in a chosen field, the higher the level of career planning that will result. This finding is also supported by the results from the multiple regression analysis, indicating that work experience is a significant predictor of career planning. This finding was not predicted a priori and, although it could be attributed to chance effects, it is logical to surmise that actual experience in various work settings is also a good teacher of the need for career planning.
Finally, the high correlation found between the CPS and NCDI scores suggests both instruments are sensitive to progressions in career planning. This finding is consistent with the high correlation found by Savickas (1984) between the CPS and NCDI (r = .47; p < .0001).
The career decisions that nurses make will not only impact their lifestyles, but will also reflect upon the nursing profession. Therefore, career decision-making is a significant concern for nursing. As a result of this study, several implications emerge regarding career decisionmaking for associate degree nursing students. Nurses lack career planning skills, indicating that the opportunity to learn the skills should be available to nurses. Second, since work experience emerged as a contributor to higher levels of career planning, nursing students should be encouraged to gain as much experience as possible. Third, the effectiveness of the structured career decision-making course suggests courses of this nature should be encouraged. Overall, the research findings point to the need to develop career planning in nursing.
Continued research is needed to establish effective and economical methods to enhance the career planning skills of nurses. Recommendations for future research include replication of this study with other types of nursing programs, replication with larger sample sizes, and replication with registered nurses.
In summary, the structured career decision-making course is an effective, economical tool to facilitate the career planning of nursing students and should be made available to the nursing community.
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MEANS AND STANDARD DEVIATIONS FOR THE PRETEST, POST-TEST, AND CHANGE SCORES ON THE CAREER PLANNING SCALE AND THE NCDI AS A FUNCTION OF TREATMENT GROUP