Do emotional intelligence and previous caring experience influence student nurse performance? A comparative analysis
Introduction
The findings of the Mid Staffordshire Inquiry (Francis, 2013) can be understood as the catalyst for a renewed focus on values in nursing, one which was already in nursing's psyche following a number of previous reports into nursing care (cf Abraham, 2011, Mental Welfare Commission Scotland, 2011, Department of Health, 2012a; BBC News http://www.bbc.co.uk/news/health-20427441; Telegraph 27/8/09 http://www.telegraph.co.uk/comment/telegraph-view/6101395/Poor-nursing-care-must-not-be-tolerated.html). However, the Francis (2013) report, its length and depth and the extent of the issues that were unearthed in relation to the provision of care at the Mid Staffordshire NHS Trust created a political backlash that landed much of the responsibility for improvement at nurse education's door. Francis' (2013) call for the development of an aptitude test for selection onto pre-registration nursing programmes has increased the focus on values based selection (Department of Health at http://francisresponse.dh.gov.uk/recommendations/191/). His recommendations also underpin the development of pre-nursing experience pilots by Health Education England (https://hee.nhs.uk/our-work/developing-our-workforce/nursing/pre-nursing-experience-pilots) predicated on the assumption that experience of working in ‘frontline health care’ prior to entering nurse education would lead to more caring and compassionate nurses.
A Department of Health review of recruitment and selection onto pre-registration nursing and midwifery programmes identifies that the NHS values (dignity, respect and non-discrimination) are central to good experiences of health care (DH, 2012b). The report goes on to state that “it is therefore important that the future education system enables initial entrants to healthcare to possess these values intrinsically and that these values are nurtured and maintained throughout their careers both in University education and Registered Professionals…” (DH, 2012b: 8). It is unclear from this statement whether it is envisaged that healthcare students should possess these values intrinsically on entry; the political desire within the UK to instigate values based selection of nursing and midwifery students onto pre-registration programmes, and the development of the pre-nursing experience pilots would indicate that this is the case. Thus there is an assumption that if you select the people with the right values into nurse education you will produce ‘better’ nurses; ones who are more compassionate and caring and will therefore prevent further catastrophic failures of care.
However, whilst there has been some work in relation to how values based selection might be undertaken (Waugh et al., 2014, Health Education England, 2014a), the concept of values based selection is problematic. It raises concerns over which values should be selected for; how these might be reliably and validly identified and measured; the scope for development of the desired values through nurse education and therefore an understanding of what students would be required to demonstrate prior to entry to their nursing or midwifery programmes (Snowden et al., 2015a).
In light of the conceptual difficulties identified above, a longitudinal study to investigate the impact of emotional intelligence (EI), demographic factors, previous caring experience and mindfulness on student nurse and midwife performance and retention across the three years of their pre-registration education was commenced in 2013 (Snowden et al., 2015a). EI relates to our ability to identify and work with our own and others' emotions, and was chosen for investigation as it is often discussed in the literature as a central part of nursing (Bulmer Smith et al., 2009) and there is evidence that EI might be linked to nurse performance. EI is also theoretically conceptualised and empirically tested in the psychology literature and there are a number of valid and reliable instruments for its measurement thus mitigating the problems related to measurement of poorly defined or conceptualised ‘values’. This paper reports on the performance related findings of the 2nd data collection period.
Section snippets
Previous Caring Experience
One of the most immediate responses to the Francis (2013) report has been the pilot testing of a period of care experience as a nursing assistant prior to application to nursing programmes (Health Education England, 2014b). Although intuitively appealing and politically expedient there is currently no evidence to connect previous caring experience with future success in nursing. Evaluation thus far indicates that students appreciate the insight into what nursing is about, which may lead to
AIM
To examine the impact of:
- 1.
Previous caring experience,
- 2.
Emotional intelligence, and
- 3.
Social connection scores, on:
Performance and retention in a cohort of first year nursing and midwifery students in Scotland.
The following hypotheses were tested:
- 1.
Previous caring experience will lead to better performance
- 2.
Emotional intelligence will be associated with performance
- 3.
Social connection scores will predict withdrawal (temporary or permanent) from the programme
Design
A quasi-experimental longitudinal approach was taken as this enabled an examination of individual students' progress in relation to the variables discussed above.
Sample
A single second year cohort of students from adult and mental health nursing, and midwifery programmes at a Scottish University (n = 598).
Measures
All participants completed EI measures on entry to year one of their programme using two validated measures: the Schutte Emotional Intelligence Scale (SEIS) (Schutte et al., 1998) (Table 2) and the
Results
Data were obtained from 598 students in total: 443 adult students, 104 mental health and 51 midwifery students. Table 4 shows the gender balance.
315 students had previous caring experience, 277 had not and 6 did not respond to the question. Fig. 1 illustrates those who had previous caring experience against those who did not according to age band. There were no statistical differences between these two groups according to age.
538 students had results recorded for all six modules. Mean(SD)
Discussion
This study has shown that those with previous caring experience performed worse than their counterparts with no such experience. The reasons for this finding are likely to be complex. For example those with caring experience in the sample had mostly gained it in care homes (approx. 50%) with a further 30% in hospital and the remaining 20% at home or other community venue. As such the definition of ‘caring experience’ was broad, however the large sample (n = 315) of those with previous caring
Conclusion
The findings presented here indicate that at this point in their programme, previous caring experience was associated with poorer academic and clinical performance. Further investigation into the impact of context, length and quality of the previous caring experience would provide a greater insight into what is most likely a complex relationship between previous caring experience and student nurse performance. Whilst total EI scores were not associated with student performance, the association
Funding
NHS Education Scotland/Scottish Government Health Directorate Delivery Group. Supporting the development of the evidence base for Recruitment, Selection and Retention of nursing and midwifery students in Scotland. Funding £24,411.
Conflict of interests
None.
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