The extent variability and attitudes towards volunteering among
The extent, variability and attitudes towards volunteering among nursing students: Implications for pedagogy in nurse education Mike O’Driscoll Sue Dyson Liang Liu Olga van den Akker Critresnurse. org Middlesex University, London UK. orcid. org/0000 -0002 -2065 -8374
Context and background: Care and Compassion in Nursing after Francis q Francis Inquiry (final report): February 2013, an apocalyptic event, a defining moment, demarcation of healthcare in the UK as pre and post Francis. q Failings in care and compassion identified at every level: including individuals, management, regulators of nursing (NMC), the nursing profession, and nurse education (Francis, 2013). q Report drew on oral accounts and written witness statements of almost 300 patients and families q Undeniable conclusion: nurses at the hospital lacked the skills to care and the inherent qualities to do so with compassion (Dyson et al, 2017) © Middlesex University | 2
What kind of nurses do we need in the NHS? q Nurses working in National Health Service (NHS) require critical thinking skills to cope with increasing numbers of severely ill patients with complex care needs, to deal with rapidly changing situations and to do so with care and compassion. q The Nursing and Midwifery Council (NMC) requires undergraduate nursing programmes to prepare nurses with critical thinking skills q Numerous strategies (reflective diaries, case studies, critical reading and writing) q Less well understood is the role of student volunteering despite the view that volunteering is thought to promote students’ self-esteem and to enhance the development of critical thinking skills (Moore and Parker, 2008). © Middlesex University Presentation title | 3
Defining volunteering NCVO (2017) defines volunteering as : ‘… any activity that involves spending time, unpaid, doing something that aims to benefit the environment or someone (individuals or groups) other than, or in addition to, close relatives. Central to this definition is the fact that volunteering must be a choice freely made by each individual’’ And for the purposes of our study, the definition of volunteering included the additional criteria that the activity took place: - While student enrolled on undergraduate nursing programme - Did not count as credit on their programmes © Middlesex University Presentation title | 4
Literature - Student Volunteering (1) q Student volunteering has a long and sometimes radical history (Brewis et al, 2010) q Almost one third of students in Higher Education (HE) volunteer and spend an average of 44 hours per year on volunteering (Mattey, 2014). q The assumption that students benefit from volunteering is largely unproven (Holdsworth and Quinn, 2010) although a meta review of volunteering literature found considerable evidence of health and well being benefits to those who volunteer and to the recipients of volunteering (Mundle et al, 2012) © Middlesex University Presentation title | 5
Literature - Student Volunteering (2) q Particular benefits of volunteering to nursing students centre on increasing the variety of social groups or situations to which students are exposed, increasing self confidence, breaking down hierarchies and greater reflection on practice through doing (praxis) (Bell et al, 2014) q Measuring any possible benefits from volunteering is a complex matter (Dyson et al, 2017; Mundle et al. 2012) © Middlesex University Presentation title | 6
Behaviourist response to Francis Report : Values-based recruitment (VBR) q an approach which attracts and selects students on the basis that their individual values and behaviours align with the values of the NHS constitution. q A major problem with the notion of values-based recruitment into nursing and midwifery is that this individualizes an issue that is more adequately conceptualized as about social relations. q Care is an emergent property of social relationships; the potential for caring cannot therefore be reduced to alleged qualities residing inside the person (Chattoo and Ahmad, 2008). q The focus on values-based recruitment not only ignores the social relations at play in contemporary nursing practice, but also perpetuates the idea that nurses are in control of the context in which they practice. © Middlesex University Presentation title | 7
An alternative approach to teaching about care and compassion q Teaching care and compassion to nurses is not straightforward in spite of the edict in the Francis Report for an increased focus on a culture of compassion at all levels in nurse education, training and recruitment (Francis, 2013) q Through provision of opportunities for students to engage in structured volunteering activities - Followed by structured learning events where student and teacher reflect on the volunteering experience in a safe environment (Buchen and Fertman, 1994) q Seen as allowing students to have more control over their learning, to gain experience in diverse settings, to break down stereotypes and develop critical perspectives (Bell et al, 2014). q Benefits of volunteering are seen partly in pedagogical terms (students in charge of their own learning) but also in terms of enhancing the potential for students to more fully understand compassionate nursing practice q We sought therefore to understand the extent, variability and attitudes toward volunteering among our students as a precursor to implementing volunteering in the nursing curriculum © Middlesex University Presentation title | 8
THE EXTENT, VARIABILITY, AND ATTITUDES TOWARDS VOLUNTEERING AMONG UNDERGRADUTE NURSING STUDENTS: IMPLICATIONS FOR PEDAGOGY IN NURSE EDUCATION. Aims: First, to understand the extent and variability of volunteering among nursing students at our University and Second, the attitudes of our nursing students towards volunteering, especially as a structured activity within the nursing curriculum © Middlesex University Presentation title | 9
Research Design q Sequential mixed methods research design: q Quantitative (survey) : helped us to understand the extent and variability of student volunteering among our nursing students q Qualitative (semi-structured) : helped us to understand the attitudes towards volunteering among our nursing students q Mixing methods allowed for the research question to be addressed sequentially (Descombe, 2008) © Middlesex University Presentation title | 10
The Survey q A 24 item self-report multiple choice questionnaire to ascertain the extent and variability of volunteering among our undergraduate nursing students q Two parts: (1) 5 sociodemographic questions, (2) 18 questions regarding volunteering experiences q Pre-tested on nursing academics q Ethical approval granted by Middlesex University Ethics Committee q Permission from nursing programme leaders to distribute questionnaires to students across the 3 year nursing programme q Participant consent assumed upon return of completed questionnaire © Middlesex University Presentation title | 11
Survey Findings q 137 of the 250 eligible nursing students completed the survey (response rate = 65%) q 79 students (58%) reported never having volunteered q 58 students (42%) had volunteered at some point q 12 of those 58 students had volunteered since joining the university q 7 of those 12 (just 5. 1% of all respondents) were volunteering at the time of our study Six main reasons for not volunteering: 1. too little time 2. nursing programme too demanding 3. lack of access to information on volunteering 4. lack of confidence to volunteer 5. uncertainty around what skills they had to offer 6. previously poor experiences of volunteering © Middlesex University Presentation title | 12
The Interviews q 10 students took part in semi-structured interviews q Of these 10 students, 2 had volunteered before studying at university q BUT, at the time of interviewing none were volunteering We asked students to talk about 3 themes arising from the survey data: 1. Lack of time to volunteer/ Volunteering while studying 2. Access to information about volunteering opportunities 3. Confidence to volunteer © Middlesex University Presentation title | 13
Interview Findings 1. Lack of time to volunteer/ Volunteering while studying ‘’We have exams that you need the extra time for, but there’s everything else as well, like extra lessons. Like dissertation workshops, and maths workshops. If I had time the extra work would be first and then second, maybe volunteering. Maybe if I had any spare time” (non-volunteering student) “we’re just really busy on the programme at the moment. I usually do the bank shift, but I haven’t done that for several months because it’s time pressures at the moment” (non-volunteering student) “I have looked at volunteering recently. Its at a soup kitchen. It’s a guy who did the same thing I did, went out to the homeless. I think if I could do that alongside my nursing I would but it all depends on time again” (nonvolunteering student, previous volunteer) © Middlesex University Presentation title | 14
Interview findings (cont) 2. Access to information on volunteering opportunities “I know we didn’t really have a fresher’s event. . it was just in the sports hall with tables with books laid out, but there wasn’t anything about volunteering” (non-volunteering student) 3. Confidence to volunteer “I lost my flat in 1998, then moved to a YMCA and I volunteered to help with homeless people, because it was an opportunity to help people who were just like me” (nonvolunteering student, past volunteer) © Middlesex University Presentation title | 15
Conclusions: Implications for Nursing Pedagogy q Nursing students share many characteristics of populations associated with increased volunteering (female, over 25) but have low levels of volunteering compared to other students q Our students, for the most part, are not volunteering due to lack of time, demands of the nursing programme, and competing priorities, although most report the benefits of volunteering to self and others - Nursing programme structure constrains uptake of volunteering (over 3 semesters to facilitate 2, 300 hours of theory and 2, 300 of practice) q The abolition of the nursing (and midwife) student bursary in favour of student loan system may impact the amount of paid work students need to do in order to pay down student debt. (Increasing cost of education has been shown to negatively impact volunteering among higher-education students (Haski. Leventhal et al, 2008) q Building structured volunteering opportunities into nursing curriculum MAY enable nursing students to reflect on practice, to avoid hierarchical thinking and adopt a critical stance towards health and healthcare practice, which positions the patient, clients and families as central to the endeavour, as opposed to the needs of the organisation (Dyson et al, 2017). © Middlesex University Presentation title | 16
Recommendations q Nurse academics should think innovatively about what constitutes learning and develop opportunities within the curriculum for structured volunteering q Nurse researchers should consider working closely with nurse academics to engage in methodologically sound educational evaluation to counteract lack of evidence around benefits of volunteering for nursing students. © Middlesex University Presentation title | 17
References q Bell, K. , Tanner, J. , Rutty, J. , Astley-Pepper, M. , Hall, R. , (2014) Successful partnerships with third sector organisation to enhance the student experience: A partnership evaluation. Nurse Education Today 35(3) pp 530 -534 q Brewis, G. , (2010) From service to action? : Students volunteering and community action in mid twentieth-century Britain. Br. J. Educ Stud 58 (4), 439 -449 q Buchen, I. H. , and Fertman, C (1994) Service-Learning and the Dilemmas of Success. National Society for Experiential Education, pp 14 -20 q Chattoo, S and Ahmad, W. , (2008) The moral economy of selfhood and caring: negotiating boundaries of personal care as embodied moral practice. Sociology of Health and Illness Vol 30, Issue 4, pp 550 -564. q Cipriano, P. (2007) Celebrating the art and science of nursing. American Nurse Today, 2(5). q Denscombe, M (2008) Communities of Practice: A Research Paradigm for the Mixed Methods Approach. Journal of Mixed Methods Research, Vol 2, No. 3, pp 270 -283 q Department of Health (2015) Culture Change in the NHS: Applying the lessons of the Francis Inquiries. HMSO 2015. q Dyson, S. E. , Liu, L. Q. , van den Akker, O. , and O’Driscoll, M. (2017). The extent, variability and attitudes towards volunteering among undergraduate nursing students: Implications for pedagogy in nurse education. Nurse Education in Practice, 23. pp. 15 -22 © Middlesex University Presentation title | 18
References cont. . q Francis Report (2013) The Mid Staffordshire NHS Foundation Trust Public Inquiry. London. The Stationery Office. http: //www. midstaffspublicinquiry. com/report Accessed 25. 10. 13 q General Medical Council (2012) Joint Statement of Professional Values Nursing and Midwifery Council and General Medical Council. http: //www. gmcuk. org/Professional_values_joint_statement__August_2012. pdf_49744505. pdf q Haski-Leventhal, D. Cnaan, R. Handy, F. Brudney, J. L. , Holmes, K, Hustinx, L (2008) Students’ vocational choices and voluntary action: A 12 nation study. Voluntas, 19(1), 1 -21 q Health Education England (2015) Raising the Bar. Shape of Caring: A Review of the Future Education and Training of Registered Nurses and Care Assistants. https: //hee. nhs. uk/sites/default/files/documents/Shape-of-caring-review-FINAL. pdf accessed 18/02/16 q Health and Care Professions Council (2016). Standards of Conduct, Performance and Ethics. HCPC. London. q Holdsworth, C and Quinn, J (2010) Student volunteering in English higher education. Studies in Higher Education, 35(1), 113 -127. q Mattey, R (2014) http: //www. theguardian. com/education/2014/feb/24/students-volunteering-week 2014 -nus-report accessed 24. 2. 14 q Moore N, B. and Parker, R. (2008) Critical Thinking (9 th Ed) Mc. Graw-Hill. New York q Mundle, C. , Naylor, C. , Buck, D (2012) Volunteering in health and care in England: A summary of key literature. The King’s Fund. London. q NVCO (2017) https: //www. ncvo. org. uk/policy-and-research/volunteering-policy accessed 28. 1. 17 q NHS England (2012) Compassion in Practice, Nursing, Midwifery and Care Staff. Our Vision and Strategy. Crown Copyright. England. © Middlesex University Presentation title | 19
Thank you for listening - (or at least for turning up!) Are there any comments or questions? For further information, please email Mike O’Driscoll: m. o’driscoll@mdx. ac. uk Professor Sue Dyson s. dyson@mdx. ac. uk Blog - Centre for Critical Research in Nursing & Midwifery http: //critresnurse. org/ Building Social Capital through a Pedagogy of Volunteerism | 20
- Slides: 20