Developing nurse match: An instrument for assessing personal nursing values against a set of preferred nursing values

This paper reports the development of Nurse Match (NM) a values-based self-report instrument for assessing the nature, relative importance and emotional significance of personal values about nursing held by nurses, nursing students or those aspiring to be nurses. The NM instrument is intended initially for use in Value Based Recruitment (VBR but can also be an aid for the charting of professional development in initial training and professional development. VBR has been introduced in the UK to address the concern that standards in nursing may be falling with students and practitioners not having the right nursing values. The development of the NM instrument and its theoretical and methodological background was first reported by Ellis et al. [1] and reference is made to that below. The instrument requires respondents to apply constructs to entities and these were chosen to indicate Nursing values. These values were derived from the literature; expert views; and most recently the preferred attributes based on NIPEC research [2], and then combined by NIPEC into six nursing values. The primary aim of the work described in this paper was to continue development of NM by piloting the instrument with a cohort of nursing students, scoring the resulting value profiles, refining scoring protocols; and obtaining feedback on user experience. A secondary aim was to explore the relationship between cohort scores on the pilot instrument and on a number of other measures of nursing competence including personal statements, selection interviews and a Multiple Mini Interview (MMI) selection process. Administration of the instrument and its scoring worked well and the scoring process for comparing respondent profiles on nursing values was refined. The instrument discriminated effectively between the nursing students responding and results conform to a normal distribution. The secondary aim of correlating with existing measures was inconclusive and is a work in progress with initial indications being of low or no correlations between the various measures of nursing values and competence. The instrument has face and content validity identifying the important nursing values, was interesting to respondents and easy to understand and complete. As a self-report measure it was considered to be superior to the personal statement used widely at present in VBR Nursing recruitment. Correspondence to: Roger Ellis,, Social and Health Evaluation Unit, School of Nursing, Ulster University, UK, E-mail: rogerellis2@icloud.com Received: May 01, 2016; Accepted: May 16, 2016; Published: May 19, 2016 Introduction Values Based Recruitment (VBR) is an important programme of work within the UK National Health Service. It was devised after a mandate DH [3] from government to Health Education England (HEE) to deliver high quality, effective, compassionate care: developing the right people with the right skills and the right values. The emphasis on the ‘right’ values is a response to a widespread concern that those recruited to nursing might not develop and evidence appropriate professional behaviour and values. VBR is an approach which recruits students, trainees or employees on the basis that their individual values and behaviours align with the values of the NHS Constitution [4]. It is about enhancing existing processes to ensure that the NHS recruits the right workforce not only with the right skills and in the right numbers, but with the right values to support effective team working and excellent patient care and experience HEE [5]. There has been an increasing focus on the values agenda across the NHS, in part due to the Francis report [6] which highlighted the vital role of the workforce in providing high quality and safe healthcare. In particular, the report emphasised the importance of staff values and behaviours for the level of care and patient experience [7,8]. The Department of Health, Social Services and Public Safety (DHSSPS) Education Strategy Group (ESG) identified a need for streamlining the application and selection processes for Higher Education Institutions (HEIs) during 2011. The Northern Ireland Practice and Education Council for Nursing and Midwifery (NIPEC) was commissioned by the ESG to undertake a project to develop a strategy which would optimise efficiency of application and selection processes to identify individuals who display attributes that are valued. Phase Two of that project focussed on the ‘attributes which are valued to realise future potential in a career in nursing’. The NIPEC report to ESG, NIPEC [2], considered that it had ‘added to the growing evidence in relation to the attributes that could be used in selecting students’. The values and attributes used in the NIPEC project are set out in NIPEC [2], at Appendix A and B. Ellis et al. [1] reported the development of a new instrumentNurse Match-to measure the nursing values held by respondents. The instrument was intended to support the value based recruitment of student nurses. Whilst other instruments existed purporting to Hogard E (2016) Developing nurse match: An instrument for assessing personal nursing values against a set of preferred nursing values Volume 1(3): 53-58 Nurs Palliat Care, 2016 doi: 10.15761/NPC.1000115 measure relevant values, none had been dedicated specifically to nursing values. Other methods used to gauge values including the assessment of a personal statement were considered to be of doubtful validity and reliability. Ellis et al. [1] located the new values based instrument, theoretically and empirically in a recent review of available instruments to measure identity and hence values [9]. From the wide range of instrument and approaches they considered Passmore et al recommended Weinreich’s Identity Structure Analysis (ISA) and instruments constructed in its framework using the associated Ipseus software. It was therefore decided to construct the Nurse Match instrument using this approach the utility of which had been demonstrated in a number of studies described in Weinreich and Saunderson [10]. An Ipseus instrument requires respondents to apply a number of bipolar constructs to entities representative of the self and its social world. These constructs and entities are chosen to reflect the salient features of the area being studied. In this case the bipolar constructs were chosen to represent key nursing values. The paper listed the nursing values used to determine the constructs in the new instrument, called Nurse Match (NM), and their derivation from the literature and interviews and focus groups with expert members of the nursing profession. The paper demonstrates how the instrument offers an in depth analysis of the respondent’s position regarding key nursing values and how initial results using an early version of the instrument demonstrated its power to identify and distinguish value orientations of individuals. The primary objective of the follow-up work described in this paper was therefore the development and assessment of the Nurse Match instrument to ensure that it was a feasible and relatively simple measure easily understood and managed. The results recorded through the instruments software had to provide a way of systematically appraising a respondent’s personal nursing values against a set of values preferred by the profession. In this sense the instrument allowed respondents responses to be ‘matched’ with an ideal set as agreed by the profession. In this case the profession’s view was captured in the six NIPEC values or ‘themed attributes’ (Table 1). It was also important to confirm that the instrument appeared valid to respondents as well as relatively easy to understand and complete and so feedback was sought from the respondents. A secondary objective was to explore the relationship between cohort scores on the pilot instrument and on a number of other measures of nursing values; personal statements, selection interviews and an MMI selection process.