integrating nursing quality with achievement and aptitude: towards assessing nursing potential
DESCRIPTION
The study integrated the qualities of nursing students (N=227) with their aptitude and academic achievement in a tripartite model. A battery of tests called in the Assessment for Nursing Potential (ANP) composed of the (a) Nursing Quality Scale (NQS) with factors on caring, compassion, commitment and connectedness; (b) Achievement test; and (c) Aptitude test was used in the study. Using a three-wave longitudinal design, the NQS was first administered followed by the aptitude, then the achievement tests. The effects of the nursing qualities on achievement and aptitude were analyzed using Structural Equation Modeling (SEM). The first model indicates that nursing quality as a latent factor has no significant effects on both achievement and aptitude, obtaining a moderate goodness of fit (RMSEA=.09). However, when the same model was tested including the effect of aptitude on achievement, it resulted to a better fit (RMSEA=.06). In the second model, aptitude has a significant effect on achievement, pTRANSCRIPT
RUNNING HEAD: Nursing Quality
Integrating Nursing Quality with Achievement and Aptitude:
Towards Assessing Nursing Potential
Carlo Magno
De La Salle University - Manila
Marife M. Mamauag
De La Salle-College of Saint Benilde
Nursing Quality
Abstract
The study integrated the qualities of nursing students (N=227) with their aptitude and academic
achievement in a tripartite model. A battery of tests called in the Assessment for Nursing
Potential (ANP) composed of the (a) Nursing Quality Scale (NQS) with factors on caring,
compassion, commitment and connectedness; (b) Achievement test; and (c) Aptitude test was
used in the study. Using a three-wave longitudinal design, the NQS was first administered
followed by the aptitude, then the achievement tests. The effects of the nursing qualities on
achievement and aptitude were analyzed using Structural Equation Modeling (SEM). The first
model indicates that nursing quality as a latent factor has no significant effects on both
achievement and aptitude, obtaining a moderate goodness of fit (RMSEA=.09). However, when
the same model was tested including the effect of aptitude on achievement, it resulted to a better
fit (RMSEA=.06). In the second model, aptitude has a significant effect on achievement, p<.05.
The model explains that attitudinal characteristics of nurses are independent of cognitive abilities
such as their aptitude and achievement, and thus supports the belief that it is possible to integrate
them in assessing nursing potential. Although effective nurses may possess the necessary
characteristics such as caring, compassion, commitment, and connectedness, these quality traits
do not affect their abilities.
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Nursing Quality
Integrating Nursing Quality with Achievement and Aptitude:
Towards Assessing Nursing Potential
Considering the growing demand of Filipino nurses abroad, there is a great need for them
to improve nursing quality by learning necessary competencies and characteristics to succeed in
the profession. Valanis (2000) argued that nurses need additional competencies in order to
function effectively. The Joint Commission on the Accreditation of Healthcare Organization also
states that nurses need to develop more competencies to perform well in their job functions.
These competencies refer to knowledge, skills, behaviors as well as personal characteristics.
Different studies on nursing quality focused on exploring trait on caring as a primary
characteristic (e. g. Blasdell & Hudgins-Brewer, 1999; Gunther & Thomas, 2006; Tise, 1988).
On the other hand, most of the studies on the achievement of nurses focused on predicting their
success using licensure examination scores as the criterion (e. g. Lam, 2000; Waterhouse &
Beeman, 2003; Giddens & Gloeckner, 2005). The current literature on nursing characteristics
and achievement were studied separately considering that there is a growing attention in
describing the complexity of nurses’ characteristics as well as their changing roles.
The present study proposes to integrate both quality and abilities of nurses because
providing services with care needs to be aligned with their ability to handle the technical aspects
of their job. The study further tested a model showing the direction from qualities of nursing
students (caring, compassion, commitment, and connectedness) directly affecting their aptitude
and academic achievement. The model implies that there should be an integration of the
knowledge, skills, and behaviors of nurses to optimize their potential for success in the nursing
profession..
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Nursing Quality
Nursing Quality Traits
Nursing quality is defined as an experiential judgment emerging from the nurse-patient
interaction. Most of the studies on nursing quality and traits focused on a single factor such as
emphasizing on nursing care while neglecting other characteristics and components. The study
by Mamauag and Magno (2005), however, elaborates varied nursing qualities extracted from
factor analysis. The resulting framework of nursing qualities does not only emphasize the
importance of caring but also other factors such as compassion, commitment, and connectedness.
In the said study, a scale composed of these four factors was constructed showing that caring,
compassion, commitment, and connectedness have items that highly load for each factor. Using
the Rasch model application, the items were further calibrated to generate a pool comprising
those that have goodness of fit. These four characteristics are culturally relevant for Filipino
nurses because they are described and defined in a collectivist orientation grounded on in-depth
interviews among nursing students and practitioner-experts. These factors of nursing quality are
all directed towards others where caring means providing comfort, compassion is sympathetic
consciousness of others, commitment is responsibility to others and to the profession, and
connectedness is the nurse-patient bond.
Valanis (2000) has a different model on nursing quality that entails the concern of
developing nursing competencies rather than personal characteristics and qualities. She
advocates that nurses must: (1) independently practice the profession and evaluate one’s own
performance, (2) have the aptitude for self-motivation and autonomy, (3) be able to identify gaps
in knowledge and plan appropriate professional development activities, (4) be able to translate
learning into practice, (5) assess patient needs, (6) elicit patient and family values, (7) provide
patients with continuity of service, (8) synthesize knowledge and skills, (9) have a broad view of
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Nursing Quality
health, (10) assess potential contribution to technology, (11) be skilled in behavior change
theory, (12) be able to differentiate nursing functions from those of other professions, and (13)
exert leadership in ensuring nursing’s unique contribution to policy on the preventive and
remedial aspects of illness. These 13 competencies proposed by Valanis calls for greater demand
from nurses to recognize their growing role in the health care profession. These competencies
entail aspects of abilities more than affective qualities. Valanis contended a more crucial need for
nurses to possess competencies rather than focus on the separate etymological concepts.
Gunther and Thomas (2006) were able to extract the same nursing characteristics found
in the study of Mamauag and Magno (2005). Using the qualitative research approach, Gunther
and Thomas explored the experiences in caring for patients in contemporary hospitals among 46
nurses. Running themes identified were the following: (1) extraordinary care giving events, (2)
incomprehensibility, (3) isolation experienced by nurses while giving care as well as profound
moment of connection with patients, and (4) questioning what other things could have been
done.
The study of Blasdell and Hudgins-Brewer (1999) used different measures to determine
the personality characteristics and attributes that guidance counselors believe to be important for
a career in nursing. It was found that “other orientation” subscale (includes traits such as
compassion, kindness, sincerity, altruism, and concern for others) was ranked the most important
followed by the academic achievement, conformity and lastly leadership. They also found out
that leadership and academic achievement is significantly more important for BSN-prepared
nurses (Bachelor of Science in Nursing) compared to those taking AND (Associate Degree in
Nursing). The study also recognized that academic achievement is the most important factor for
a career in medicine than in nursing. It is also important to note in the study of Blasdell and
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Nursing Quality
Hudgins-Brewer that nursing students need to be compassionate, kind, obedient, and moderately
academically able. This moderate achievement level is enough evidence pointing to the need for
nurses to improve their cognitive abilities such as critical, thinking, achievement, and aptitude as
advocated by Valanis (2000).
Guidance counselors had realistic perceptions of nursing and identified personal and
cognitive attributes of students that would promote success in nursing as investigated by Bolan
and Grainger (2005). This supports the earlier findings of Blasdell and Hudgins-Brewer (1999).
However, Bolan and Grainger further argued that nurses involved in the recruitment of students
need to ensure that guidance counselors have more accurate perceptions of the changing role of
nurses, their opportunities for practice outside hospital settings, and the importance of problem-
solving and leadership skills for nurses. Considering that high school guidance counselors can
influence the career choices of students, it is also imperative that they be equipped with
information on what characteristics will make successful, competent and caring nurse-
practitioners.
Nursing Achievement and Aptitude
Majority of studies in nursing shows that nursing achievement is moderately perceived as
important. This concerns a great concern to improve the abilities of nurses such as their aptitude
and academic achievement. The common measure of nursing achievement in published studies
on nursing education can be found in the results of licensure examinations such as the NCLEX
(National Council Licensure Examination). In the Philippine setting, the Philippine Regulation
Commission also uses a test for the licensure of nurses, although there are no published studies
using the said instrument.
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Nursing Quality
Three studies are published in reviews using the NCLEX as a measure of nursing
achievement. The study by Lamm and McCaniel (2000) used the State Board Test Pool
Examination (SBTPE), Grade Point Average (GPA), parental education level, and age as
predictors of the NCLEX. The purpose of the study was to identify which variables accurately
predict the success of practical nursing students on the NCLEX-PN. The results indicate that
among all predictors, the General Mental Ability (GMA-subscale of SBTPE) was the only
significant predictor of the NCLEX-PN. A recent study by Waterhouse and Beeman (2003) was
able to identify more significant predictors of the NCLEX such as scores in the Risk Appraisal
Instrument (RAI), grades in the different nursing courses, and the nursing achievement test. In a
more recent study, Giddens and Gloekner (2005) investigated the relationship between critical
thinking and the performance scores on the NCLEX. Their study showed that both measures of
critical thinking (California Critical Thinking Test and California Critical Thinking Disposition
Inventory) did not significantly predict the NCLEX scores. The study recognized the need to
explore other dispositional variables in explaining nursing achievement scores.
The studies on nursing achievement usually correlated other cognitive measures such as
critical thinking, mental ability, grades, with demographic factors such as age, gender, and
parents’ educational level. Previous studies did not explore other dispositional factors such as
nursing quality traits in predicting nursing achievement levels because these concurrent studies
were driven by the factors explained by other previous studies. This poses a need to explore and
use other kinds of disposition such as quality traits in explaining nursing achievement and
aptitude.
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Nursing Quality
Conceptual Framework
Valanis (2000) proposes that there should be an integration of the knowledge, skills, and
behaviors of nurses and there should be a framework to explain this. Most studies on nursing
achievement use other cognitive factors to predict nursing achievement and this pattern results to
very limited models in explaining nursing affect and cognition. This study tested a model
integrating nursing quality traits as a latent variable composed of caring, commitment,
connectedness, and compassion with achievement and aptitude in nursing. This integration is
based on Bandura’s framework of triadic reciprocity of the social cognitive theory. The said
framework contends that human functioning is explained in terms of a model of triadic
reciprocality in which behavior, cognitive and other personal factors, and environmental events
all operate as interacting determinants of each other (Bandura, 1986). In applying this
framework, the nurses’ function is made more effective by the interaction of their quality traits as
personal factors, and their achievement and aptitude as cognition. In the present study, two
models were tested: one model testing the effect of nursing quality traits on achievement and
aptitude, and another model, the effect of aptitude on achievement was included.
Method
Participants
A total of 227 second year college nursing students from a private educational institution
participated in the study. Their ages range from 16-18 years old.
Instruments
The Assessment for Nursing Potential (ANP) was used as the research instrument of this
study. Developed by the Asian Psychological Services and Assessment, Inc., the ANP is a valid
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Nursing Quality
and reliable measure to form a strong base for selecting students for admission to the upper
nursing division level. It is composed of a combination of three tests, namely: (1) nursing
attitudinal inventory (earlier known as the Nursing Quality Scale) which assesses the traits that
are essential in contributing to one’s success in the nursing profession; (2) aptitude test that
measures the “innate-based” learned abilities; and (3) achievement test measuring what has been
learned in the lower nursing division level. The ANP test battery has been widely used by
nursing schools in the Philippines. It is the only locally-made test used for selection and
placement of nursing students. It has been seen as a good preparation for the Nursing Board
Examinations and foreign-based tests such as the NCLEX and CGFNS.
Nursing Quality Scale (NQS). Developed by Mamauag and Magno (2005)which
measures nursing quality traits with factors such as caring, commitment, compassion, and
connectedness. It is composed of 160 items with 40 items for each factor, using a 4-point Likert
scale (4-strongly agree, 3-striongly disagree, 2-disagree, 1-strongly disagree). High scores
indicate possession of strong characteristics of the domains measured. Two forms of the NQS
obtained high correlation coefficients. The test also indicates a very high internal consistency
among the items with a Cronbach’s alpha value of .95. Principal components analysis with
varimax rotation was conducted where the items highly loaded for each factor. All items in the
calibration procedure using the IRT application of the Rasch Model indicated high goodness of
fit.
Nursing Achievement Test. The achievement test measures the proficiency in the general
education course taken during the first two years of the nursing education. The subscales include
general psychology, college algebra, physical science, life science, and communication skills.
The Cronbach’s alpha for the subscales are .55, .60, .37, .63, and .86, respectively. The overall
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Nursing Quality
internal consistency of the scale is .86. The items were reviewed by three measurement experts
to establish the instrument’s content validity. Factor analysis was conducted where the items
highly loaded on their specified subscales. All the factors measured in the nursing achievement
test are significantly related with each other.
Nursing Aptitude Test. The aptitude test measures fundamental intellectual abilities. It
consists of abstract reasoning, verbal reasoning, and numerical reasoning. The Cronbach’s alpha
for the subscales are .43, .75, and .75, respectively. The overall internal consistency of the items
is .83. Content validity of the items was established through a review by three content area
experts. Factor analysis was conducted to establish the construct validity of the test. Significant
correlations were obtained for each subscale.
Procedure
The three tests (NQS, achievement and aptitude) were administered to second year
college students in a private nursing school in the Philippines. The tests were accomplished by
the nursing students as part of their annual diagnostic assessment. The researchers ensured that
the standard procedures of test administration were followed. The instruments were administered
in three time waves. The NQS was first administered, followed by the aptitude, and finally the
achievement. After three subsequent test administrations, the students were debriefed about the
purpose of the study and their permission was asked to include their test scores as part of the
analysis in this study.
Data Analysis
The Pearson’s r was used to determine the inter-correlations among the factors in the
subscales of each test.
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Nursing Quality
The Structural Equation Modeling (SEM) was the primary analysis used in this study.
The SEM is a statistical technique that takes a confirmatory approach to the analysis of a
structural theory bearing certain constructs or concepts. Typically, this structural theory
represents “causal” processes that generate observations on multiple variables.
Applying the SEM, two models were tested in the study. In the first model (the default
model), the effects of NQS on achievement and aptitude were tested. In Model 2 (constrained
model), the same paths were tested but this time the effects of aptitude on achievement included.
The obtained Root Mean Square Error Approximation (RMSEA) was used to determine the best
fitting model, as well as measures of noncentrality and single sample fit indices. Single sample
goodness of fit indices were also used to evaluate the models (Joreskog GFI/AGFI, Akaike
Information Criterion, Schwarz's Bayesian Criterion, Browne-Cudeck Cross Validation Index,
Bentler-Bonett, James-Mulaik-Brett Parsimonious Fit Index, and Bollen's Rho).
Results
Table 1 shows the mean scores and standard deviations of the NQS factors as well as of
the achievement and aptitude tests. In the NQS, the respondents obtained high scores across all
factors that are close to the highest score of 4.00. Scores on the achievement and aptitude scales,
on the other hand, are moderate where most respondents obtained scores within the mean range.
These scores may be interpreted that the students are apparently not meeting the standards of
nursing education that they have earned so far in their first two years.
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Nursing Quality
Table 1
Mean and Standard Deviation of the NQS, Aptitude, and Achievement
M SD
Nursing Quality Scale (NQS)
Caring 3.81 0.41
Compassion 3.80 0.38
Commitment 3.87 0.37
Connectedness 3.51 0.42
Achievement
Psychology 73.12 4.34
Algebra 67.29 5.99
General Science 69.37 5.03
Life Science 69.37 4.89
Communication 78.52 4.89
Overall Achievement 71.53 2.90
Aptitude
Abstract Reasoning 77.96 6.81
Verbal Aptitude 75.19 5.99
Numerical Aptitude 73.87 5.42
Overall Aptitude 75.71 4.49
To establish the relationship among the factors, Pearson’s r was used. Table 2 shows the
matrix of the correlation coefficients. The factors of the NQS are significantly correlated with
each other, p<.05, although they do not correlate highly with the factors of achievement and
aptitude. Only the factor on compassion correlated significantly with the factors on verbal and
numerical aptitude. No significant correlations were found between the factors of the NQS with
any of the achievement factors. Some of the achievement factors, however, are significantly
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Nursing Quality
related with some factors of the aptitude component. Moreover, the scores on psychology
achievement are significantly related with all the factors of the achievement and aptitude scales.
Table 2
Correlation Matrix among the Factors of NQS, Aptitude, and Achievement
1 2 3 4 5 6 7 8 9 10 11 12
(1) Caring 1.00
(2) Compassion 0.77* 1.00
(3) Commitment 0.83* 0.79* 1.00
(4) Connectedness 0.72* 0.68* 0.69* 1.00
(5) Psychology -0.03 0.07 -0.03 0.03 1.00
(6) Algebra 0.03 0.08 0.00 0.01 -0.20 1.00
(7) General Science -0.05 0.00 -0.06 -0.01 0.25* -0.01 1.00
(8) Life Science -0.05 0.05 0.03 0.07 0.17* 0.17* 0.10 1.00
(9) Communication 0.08 0.13 0.10 0.11 0.24* 0.10 0.25* 0.04 1.00
(10) Abstract Reasoning -0.01 0.07 0.00 0.04 0.16* 0.03 0.13* 0.07 0.10 1.00
(11) Verbal Aptitude 0.09 0.22* 0.08 0.15* 0.42* 0.01 0.07 0.10 0.35* 0.20* 1.00
(12) Numerical Aptitude 0.01 0.16* 0.07 0.04 0.25* -0.08 0.17* 0.21* 0.31* 0.39* 0.39* 1.00
*p<.05
The Structural Equation Modeling was conducted to test the integration of nursing quality
traits with achievement and aptitude in a model.
The default model has rather an acceptable fit with a RMSEA of 0.096. The noncentrality
fit indices and single sample fit indices are consistent in declaring a rather good fit of the model.
In the path estimates, all factors are significant components of their latent construct. The path
estimates show that nursing quality does not significantly affect both aptitude and achievement
(see Figure 1).
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Nursing Quality
Figure 1
Default Model
NursingQuality
Compassion Commitment ConnectednessCaring
.33*0.37*.34*.33*
Aptitude Achievement
.32 .12Algebra
GeneralScience
Life Science
Communication
Psychology
.90*
1.00*
.95*
.91*
.46*Verbal Aptitude
AbstractReasoning
NumericalAptitude
.89*
1.48*
1.00*
31.07*
e5
19.93*
e6
22.52*
e7
18.90*
e8
12.92*
e9
.03*
e1
.04*
e2
.02*
e3.07*
e4
9.42*
e13
5.82*
e14
36.71*
e10
28.25*
e11
8.52*
e12
The second model is a constrained model where the same paths are studied with the
inclusion of the effect of aptitude on achievement. The constrained model is a better fitting
model as compared with the default model with a RMSEA value of 0.067, all other noncentrality
fit indices and single sample fit indices also showing improvement. The path estimates are
consistent with the first model where nursing quality has no significant effect on aptitude and
achievement, but it is shown that aptitude has a significant effect on achievement, p<.05. When
the effect of aptitude on achievement was included, the path estimates from nursing quality to
aptitude increased and the effect on aptitude became negative although not significant.
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Nursing Quality
There are changes in the parameter estimates for aptitude in the constrained model. The
errors for each factor increased except for the verbal aptitude. The errors for both aptitude and
achievement as endogenous variables decreased in the constrained model (e13 and e14).
Figure 2
Constrained Model
NursingQuality
Compassion Commitment ConnectednessCaring
.33*0.37*.34*.33*
Aptitude Achievement
.41 -.17Algebra
GeneralScience
Life Science
Communication
Psychology
.98*
1.00*
.75*
1.02*
.53*Verbal Aptitude
AbstractReasoning
NumericalAptitude
1.15*
1.28*
1.00*
30.36*
e5
22.01*
e6
22.19*
e7
17.94*
e8
13.10*
e9
.03*
e1
.04*
e2
.02*
e3.07*
e4
8.80*
e13
1.57*
e14
37.27*
e10
23.85*
e11
14.53*
e12
.68*
In comparing the two models in their fit indices, the default model has a larger
discrepancy function (0.60) as compared to the constrained model (0.37). In the same way the
RMS standardized residual for the default is larger (0.098) than the second model (0.052). The
Maximum Likelihood chi-square values decreased from the default (2=160.618) to the second
model (2=102.30) which shows improvement in the model.
In terms of the model’s noncentrality indices, there is consistent improvement in fitting
the data from the default model to the constrained model. The Population Noncentrality
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Nursing Quality
Parameter decreased (model 1=0.32, model 2=0.12) as well as the RMSEA (model 1=.07, model
2=.04). The McDonald Noncentrality Index (model 1=0.85, model 2=.94), Population Gamma
Index (model 1=0.94, model 2=0.98), and Adjusted Population Gamma Index (model 1=0.92,
model 2=0.97) all increased. All other goodness of fit indices likewise improved in the
constrained model (see Table 3).
Table 3Single Sample Fit Indices
Goodness of Fit Indices Default Model Constrained Model
Joreskog GFI 0.901 0.933
Joreskog AGFI 0.851 0.898
Akaike Information Criterion 212.618 156.299
Schwarz's Bayesian Criterion 1.219 1.016
Browne-Cudeck Cross Validation Index 0.839 0.622
Independence Model Chi-Square 933.096 933.096
Independence Model df 15.047 15.047
Bentler-Bonett Normed Fit Index (NFI) 0.838 0.897
Bentler-Bonett Non-Normed Fit Index (TLI) 0.851 0.928
Bentler Comparative Fit Index (CFI) 0.883 0.945
James-Mulaik-Brett Parsimonious Fit Index (PCFI) 0.696 0.730
Bollen's Relative Fit Index (RFI) 0.795 0.867
Bollen's Incremental Fit Index (IFI) 0.885 0.946
Discussion
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Nursing Quality
Is the Integration of Nursing Quality with Ability Measures a Good Model?
Integrating nursing quality with both aptitude and achievement shows a considerable
good fit for the proposed model and more so with the constrained model as indicated in the
noncentrality fit indices and single sample fit indices. The good fit of the resulting model may be
attributed to the three distinct measures of the NQS, Aptitude, and Achievement tests.
Considering that these all belong in a single test battery, the participants of the study most likely
saw the parallelism in the measures used. It also indicates that the structure of the three variables
fit together because all the items were calibrated with person ability by using the same one
parameter Rasch model in a binary response type of scaling (“0” and “1”). The technique of
calibrating the infit and outfit characteristics of items for all the factors in a model increases its
fit indices.
Unlike earlier studies that generated multivariate procedures, the SEM takes a
confirmatory rather than exploratory approach to data analysis as illustrated in this study. While
most of the multivariate techniques from previous studies provides regression and predictive
models of nursing achievement, the present study showed that the factors of nursing quality,
achievement, and aptitude fits together in a structural model. As depicted in this study, the
constructs of nursing quality, aptitude, and achievement in nursing were shown to be
independent measures of both non-cognitive and cognitive abilities. The integration of the
nursing quality with ability measures was apparently good as a model but the model also showed
that affective qualities are independent of cognitive abilities.
Aside from citing statistical considerations and benefits of using the SEM and Rasch
model applications as shown in this study, nurses in the academic setting are expected to possess
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Nursing Quality
all the necessary competencies, skills, attributes to be effective in their profession (Valanis,
2000).
Do Nursing Quality Traits affect Ability Measures?
Nursing quality traits do not affect ability measures, but aptitude affects achievement in
nursing. These findings support previous models of using cognitive factors to predict cognitive
criterion as well. Current literature describes nursing licensure exams like NCLEX as a measure
of nursing achievement. Most often, studies indicate factors such as general mental abilities,
Grade Point Average (GPA), parental education level and age as best predictors of success in
passing board examinations. None ever described yet that empirically, personality or personal
attributes can also predict success in the nursing profession.
The findings indicate that affective measures such as traits are not good predictors of
ability measures such as achievement and aptitude. The nursing traits having no effect on both
aptitude and achievement further indicate that nursing quality is distinct with the two ability
measures. The distinction is indicated by the nature of the constructs itself – where the nursing
traits are non-cognitive and the ability measures as cognitive. The traits were self-reported that
may be subject to social desirability in the measurement, while the ability measures are tests of
one’s achievement and aptitude that are assumed objective. Previous studies that used affective
predictors also did not yield significant effects for ability measures like the risk appraisal
assessment (Waterhouse & Beeman, 2003).
Apparently there is a need to explore and use other measures of disposition aside from
quality traits in explaining nursing aptitude and achievement. However, the belief that human
functioning includes behaviors, person variables, and the environment that are interacting with
and shaping with one another (Bandura, 1986) has been further strengthened as indicated in the
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Nursing Quality
resulting model tested in this study. Further studies can include other disposition measures such
as interest, motivation, and self-efficacy in exploring the predictability of successful careers in
nursing. A further analysis using a larger sample needs to be undertaken to increase the power of
the statistics.
References
Bandura, A. (1986). Social foundations of thought and action: A social cognitive
theory. Englewood Cliffs, NJ: Prentice Hall.
Blasdell, A. & Hudgins-Brewer, S. (1999). High school counselors’ perceptions of
the academic and personality attributes important for a career in nursing.
Journal of Nursing Education, 38, 176-179.
Bolan, C. M. & Grainger, P. (2005). What do high school guidance counselors
really think of nursing? Journal of Nursing Education, 44, 135-138.
Giddens, J. & Gloekner, G. (2005). The relationship of critical thinking in
performance on the NCLEX-RN. Journal of Nursing Education, 44, 85-89.
Gunther, M. & Thomas, S. (2006). Nurses’ narratives of unforgettable patient
care events. Journal of Nursing Scholarship, 4, 370-377.
Lamm, G. & McCaniel, A. (2000). Factors that predict success on the NCLEX-
PN. Journal of Nursing Education, 39, 315-318.
Mamauag, M. & Magno, C. (2005). Nursing quality scale: Test development.
Unpublished manuscript, Asian Psychological Services and Assessment, Inc.
Tise, S. (1988). To be or not to be a registered nurse. Occupational Outlook
Quarterly. 32, 8-17.
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Valanis, B. (2000). Professional nursing practices in an HMO: The future is now.
Journal of Nursing Education, 39, 13-26.
Waterhouse, J. & Beeman, P. (2003). Predicting NCLEX-RN success: Can it be
simplified? Nursing Education Perspectives, 24, 35-40.
Author’s Note
This study was presented at the 7th Biennial Conference of the Asian Association of Social
Psychology (AASP 2007) at Kota Kinabalu, Sabah, Malaysia, July 25-28, 2007. Further
correspondence can be addressed to Mr. Carlo Magno, Counseling and Educational Psychology
Department, De La Salle University-Manila, [email protected] and Marife Mamauag, Center
for Learning and Performance Assessment, De La Salle-College of Saint Benilde,
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