Research Doctorate - Doctor of Philosophy (PhD) / The phenomenon of belongingness has intuitive appeal. Empirical literature from the disciplines of social science and psychology reveals that the need to belong exerts a powerful influence on cognitive processes, emotional patterns, behavioural responses, health and wellbeing, and that failure to satisfy this need can have devastating consequences. There are assertions that people who are deprived of belongingness are more likely to experience diminished self-esteem, increased stress and anxiety, depression, a decrease in general wellbeing and happiness, impaired cognition and an increase in affiliative behaviours, such as compliance and conformity. In the nursing literature, while there is paucity of studies about this salient issue, there are inferences that diminished belongingness may impede students' motivation for learning and influence the degree to which they are willing to conform rather than adopt a questioning approach to clinical practice. These findings are of concern to a profession that seeks to prepare innovative, confident, competent professionals with a commitment to self-directed learning; and they require careful investigation. This study set out to identify the relationship between belongingness and the clinical placement experiences of pre-registration nursing students by measuring the extent to which students experience belongingness related to their clinical placements, and by exploring the factors that impact on and are consequences of that experience. Third-year students were recruited from two Australian universities-one in New South Wales and one in Queensland-and from one university in the south of England. This was a mixed-method case study where 362 students participated in an anonymous online survey termed the Belongingness Scale-Clinical Placement Experience (BES-CPE), and 18 of those students participated in in-depth semi-structured interviews. The quantitative data from the survey were subjected to descriptive and inferential statistical analysis. In comparing the extent to which nursing students experience belongingness, it was determined that the mean BES-CPE scores of participants from the university in England were statistically higher than participants from either of the Australian universities. This finding may be partly explained by differences in the duration of clinical placements and the mentorship models in use at the three universities. Of the demographic variables analysed, previous or concurrent nursing experience, family members with nursing experience, gender and country of birth were not a strong influence on students' experience of belongingness. The effects of age and English as a first language were less certain. The qualitative interview data were thematically analysed. The experiences and perspectives of the participants from each of the three sites were remarkably similar in many respects. They described placement experiences that spanned a continuum from those that promoted a high degree of belongingness to those that provoked intense feelings of alienation. Belongingness was seen to be both a deeply personal and a contextually mediated experience. It was the interpersonal relationships forged with the registered nurses that students worked with on a day-to-day basis that exerted the single most important influence on their sense of belonging. However, students' sense of belonging was also influenced by a range of other individual, interpersonal, contextual and organisational factors. A number of important consequences of belongingness were identified. These included affective consequences such as feeling safe, comfortable, satisfied and happy within the clinical environment. Belongingness was related to nursing students' self-concept, degree of self-efficacy, the extent to which they were willing to question or conform to poor practice, and their future career decisions. However, it was the relationship between belongingness and students' capacity and motivation for learning to nurse that emerged as a critical and recurring theme. Given that clinical placements are specifically designed to facilitate authentic learning opportunities, this is a significant finding that has repercussions at both the micro and macro levels. By way of conclusion the practical implications of the study are brought to the foreground and made explicit through the presentation of the conceptual framework that emerged from the study. The Ascent to Competence conceptual framework applies a modified version of Maslow's hierarchy of needs to the clinical placement experience of nursing students, and sheds light on the challenges associated with the particular needs of students who are learning to nurse in contemporary practice environments.
| Identifer | oai:union.ndltd.org:ADTP/222137 |
| Date | January 2007 |
| Creators | Levett-Jones, Tracy Lynn |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | Copyright 2007 Tracy Lynn Levett-Jones |
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