Nuirsing has embraced the value of baccalaureate education for nursing practice. Themes on the value and role of liberal education abound in current nursing literature. Witt (1092) suggests baccalaureate education may increase graduates' abilities to use the self in a skillful and effective way, while accomplishing the re&ponaibuitieB of their jobs. Hagerty and Early (1992) examined the role of liberal education in practice and from this work proposed a model of practice that appears influenced by liberal education. Their more recent work (Hagerty & Early, 1993) explores RNa' perceptions of liberal education, including its personal and professional impact. Their findinge suggest issues educators may esamine to promote the acquisition of IiV eral education and ite integration with professional practice.
Although these and other authors (Bottoms, 1988; Hanson, 1991; Nelson, 1978) support the value of baccalaureate education for nursing practice, Sakalys and Watson (1985, 1986) believe professional preparation does not belong at the baccalaureate level. Dustin (1978) and Simms (1989) hold similar beliefs. However, Morse, Bottoms, and Wastlick (1992) believe it IB counterproductive for the nursing profession to consider separately liberal and professional education. Gillis (1989) postulates the successful outcome of a liberal professional education for nurses is contingent on the integration and balance of the liberal and professional components.
The issue of the value of a liberal education for nurses has been compounded by the current influx of RN students into baccalaureate nursing programs. Distance education is one way to access poet-RN baccalaureate education. In fact, distance education is an alternate delivery system increasing in popularity BB a means to address the educational needs of RNs desiring to obtain a BScN. Although the literature provides some support for distance education as an alternative delivery system (Craig, 1991; Gillis, Perry, & Faraona, 1993; Keck, 1992), measurements of the effectiveness of distance education need to be researched. The question remains: How well does the present system of baccalaureate education serve the nurse, both as a person and as a professional?
The literature doee provide some support for the value of a liberal education for the nursing profession. However, there is a paucity of information related to the value of a baccalaureate degree for post-RN studente returning to the inuveraitj. A need remains to examine the value of a liberal education for this unique group of learners. Therefore, the purpose of this longitudinal study was to examine the relationship among liberal education competencies as demonstrated in the personal and professional Uves of post-RN baccalaureate students and time spent in a BScN program. The first phase of this study has been reported elsewhere (Gillis et al,, 1993). The following questions were addressed in phase two of this research.
* What competencies of the liberally educated person are demonstrated in the personal lives of post-RN students enrolled in a BScN program?
* What competencies of the liberally educated person are demonstrated in the professional lives of poat-RN students enrolled in a BScN program?
* Does change occur over time in the demonstrated liberal education competencies öS poat-RN students enrolled in a part-time, distance BScN program?
The six competencies identified by Dreeeel ( 1979) and used by Bottoms ( 1988) to define the liberally educated person provided the framework for this study. The Dreeeel competencies have been validated in the literature as being representative of the universe of competencies that are anticipated outcomes of baccalaureate nursing education. These competencies are knowledge, communication, values, collaboration, citizenship, and integration.
Liberal Education consists of those learning activities within the curriculum other than the specific professional nursing learning experiences. Personal behavior ie a competency that is an outcome of Uberai education and demonstrated in nurses' lives through activities not directly related to nursing (Bottoms, 1988). Personal behaviors were measured on Part I of the research instrument. Professional behavior is a competency that IB an outcome of liberal education and demonstrated in nurses' lives through activities directly related to nursing (Bottoms, 1988). Professional behaviors were measured by scores on Part II of the research instrument.
Sample. A convenience sample of 126 RNs enrolled in a part-time baccalaureate distance education nursing program volunteered to participate in the study. Data collection began in January 1989 and was completed in March of 1994. A self-report questionnaire developed by Bottoms (1988) was distributed by mail to 126 nurses at the beginning of then- BScN program to obtain baseline data (Time 1). Ninety-eight (77.1%) subjects returned the questionnaire in stamped, addressed envelopes to the researchers. The instrument was distributed at four other intervals during the 5-year period of the program: 96 questionnaires were distributed at Tune 2, 86 at Time 3, 78 at Time 4, and 76 at Time 5. Eighty-six (89.6%) subjects completed the study questionnaire at Time 2, 79 (92%) subjects completed the study questionnaire at Time 3, 75 (96%) at Time 4, and 74 (99%) at Time 5. A probable reason for this high rate of return may be related to the loyalty of students to their program of studies. The subjects who failed to complete all five questionnaires were removed from the data analysis. Data analysis was, therefore, based on a sample of 68 subjects. The main reason of attrition from the study was subjects withdrawing frota the program of study.
The educational background of the subjects varied with 40 (58.8%) prepared in 2-year diploma programs and 28 (41.2%) prepared in 3-year diploma programs. Demographic characteristics indicated the majority of subjects were married (73.5 %), employed full-time or parttime (95.6%), and worked in staff nurse positions (61.8%).
Instrument. A two-part instrument, (Part I personal. Part ? professional) constructed by Bottoms (1988) was used for data collection. Part I contained 24 behaviors that applied the competencies of liberal education to nurses' personal lives. Part II contained 23 behaviors that applied the competencies to nurses' professional Uves. The competencies included knowledge, communication, values, collaboration, citizenship, and integration. There are four behaviors for each of the six competencies. Subjects were asked to respond "yes" or "no" to each item based on their behavior in the previous year. The instrument was scored using "1" for a "yes" response and "2" for a "no" response. Therefore, a low score represents a higher range of behaviors reported. The possible score range for each competency was 4 to 8. The possible range for the total score was 24 to 48. Levels of probability were computed at .05 level.
Bottoms (1988) reported a reliability coefficient KR-20 (Kunder-Richardson-20, JV = 565) of .82 for Part I (personal), .82 for Part ? (professional), and .89 for the total score.
The reliability coefficient for this study (W = 68) was .72 for Part I, .76 for Part II, and .84 for the total score.
The Statistical Package for the Social Sciences was used for data analysis. To determine differences in liberal education competencies as demonstrated in the personal and professional lives of post-RN baccalaureate students and time spent in a BScN program, repeated measures analysis of variance and Scheffe post hoc tests of means were computed. Cases with missing data on a variable were omitted from the analysis.
The Table presents a summary of the mean scores on individual behavioral competencies for Times 1 through 5. Scores for the competencies of liberal education as demonstrated in the personal and professional lives of subjects showed improvement in all six categories of knowledge, communication, values, collaboration, citizenship, and integration following exposure to baccalaureate-level course work.
To test the effect of the independent variable of baccalaureate-level course work on demonstrated competencies of Uberai education in the personal and professional lives of subjects, a repeated measures, one-way analysis of variance procedure was used. Significant differences were found in the competencies in the personal lives of RN learners in the areas of collaboration (f [4,332] = 2.96, ? < .02), knowledge (f [4,332] = 5.44,p < .00), integration <f [4,330] = 2.43 ? < .05) and the total score if [4,320] = 4.38, ? < .002). When the Scheffe test was applied at the .05 level, the scores for the competencies in all six categories were not statistically different from Time 1 through Time 5. There was, however, a statistically significant difference in the overall scores at the .05 level between Time 1 and Time 5.
Similarly, significant differences were found in the competencies as demonstrated in the professional lives of RN learners in the areas of collaboration (f [4,330] = 3.49, p < .01), values if [4,332] = 6.08, p < .01), knowledge (f [4,329] = 7.72, p < .01), integration (/"[4,326] = 3.14, p < .01), communication if [4,330] = 7.76, p < .01), and total score (f [4,3191 = 9.47, p < .01). Although improvement was noted in the area of citizenship, the difference was not statistically significant if [4,329] = 1.99, p > .05).
The Scheffe scores at the .05 level for the competencies of liberal education as demonstrated in the professional lives of nurses differed significantly in the areas of communication, values, and knowledge. For communication, significant differences occurred between Time 1 and Times 3, 4, and 5. For values, significant differences occurred between Time 1 and Time 4, Time 1 and Tune 5, and Time 2 and Time 5. For knowledge, significant differences occurred between Time 1 and Time 3, and Time 1 and Time 5. In addition, there was a significant difference on the overall acore of liberal competencies as demonstrated in the professional lives of the nurse between Time 1 and Time 4 and Time 5, Time 2 and Time 5, Time 3 and Time 5. To summarize, there was a significant difference in the total overall score (Part I and Part ?) of liberal competencies as demonstrated in both the personal and professional lives between Time 1 and Time 5, and Time 2 and Time 5.
Mean Scores for Personal and Professional Competencies by Time (M = 68)
Because the sample was a convenient one selected from a snudi university, caution must be used in interpreting the results. Students who selected not to return the mailed questionnaires may have answered the research questions differently than those who did respond. Perhaps those subjects chose not to subscribe to exploring new models of nursing care delivery consistent with the scope of concepts and theory found in a baccalaureate program (Watson & Phillips, 1992), therefore, introducing sampling bias. Then, the results of this study may not be generalizable to the population of post- RN learners.
After 5 years of part-time study at the baccalaureate level, subjects demonstrated significant differences in their personal and professional lives. This evidence suggests nurses with a baccalaureate degree apply their liberal education in both their personal and professional lives. These findings concur with the work of Bottoms (1988), McCloskey et al. (1990), and Hagerty and Early (1993). It is interesting to note that behaviors reflective of the competencies of liberal education (e.g., taught a concept or activity addressing health promotion, assisted in initiating action on a change in nursing practice) developed sooner and applied more in the professional lives of the nurses than in their personal lives. This is in contrast to the findings of Bottoms (1988) whose subjects reported more behaviors applied in their personal lives than in their professional lives, suggesting the work setting may hinder the full use of nursing abilities. The sample in Bottoms' research consisted of practicing generic baccalaureate graduates. Post-RN baccalaureate learners may face different personal, work, and career issues than generic baccalaureate practicing nurses, and these issues impact differently on the competency performance of both groups.
Post-RN students have been described as highly motivated adult learners, often managing family and work responsibilities while seeking further education (Kearney, 1994). In addition, women are the providers of family health care needs and often assume responsibility for family and cultural celebration, such as school, church, and neighborhood projects (Pacione, 1994). Home (1992) noted that while the strengths of women studying nursing include their motivation and their life and work environment, their main difficulties include time constraints, role conflict, and working under unfavorable learning conditions. Therefore, competencies as demonstrated in the personal lives of RN learners lagged behind the development of competencies as demonstrated in the professional lives of post-HN learners.
While demands of part-time study by distance for this sample may have allowed little time for post-RN learners to demonstrate competencies in their personal lives, the role of frequent communication with en-campus faculty and interaction with local educational consultants over the course of study may have enhanced the development of personal competencies.
The peer group may be another factor in facilitating the consistent development of professional competencies (Craig, 1991). The students in this sample tended to associate with fellow students enrolled in the BScN program and in. the same courses. The peer group provided the post-RN learners with support if they had problems and acted as a sounding board for the ideas, theories, and concepts they were discovering.
Implications for Nursing
Academic institutions must consider initiating innovative educational reform guided by research. Fundamental in educational reform is the development of baccalaureate programs for post-RN learners that focus as much on the development of the individual as a person as on the development of the professional nurse. The findings of this study suggest that with the present system, the personal competencies lagged behind the development of professional competencies. A mature, liberally educated professional is needed to work collaboratívely with other health care professionals to address the health care needs of individuals, families, and communities.
This study contributes to a growing body of nursing research studying the impact of liberal education on the personal and professional lives of post-RN studente returning to the university to earn a baccalaureate degree in nursing by means of distance education. This study also provides important insight into the impact of Uberai education on the development of the person and on the knowledge, skills, and attitudes specific to the profession.
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Mean Scores for Personal and Professional Competencies by Time (M = 68)