Author Identifier

Edah Anyango

https://orcid.org/0000-0002-8677-5047

Date of Award

2024

Document Type

Thesis - ECU Access Only

Publisher

Edith Cowan University

Degree Name

Doctor of Philosophy

School

School of Nursing and Midwifery

First Supervisor

Irene Ngune

Second Supervisor

Esther Adama

Abstract

Background: The final year of nursing education has been identified as an eminent stage for nursing students, particularly its clinical placement component, as this is the time students make career decisions by selecting a practice destination from the different nursing specialties for their graduate year and beyond. Previous studies provide evidence of nursing students’ career preferences and specialty choices. This evidence suggests that nursing students prefer a professional career in hospital settings, which has led to reduced career interest in non-hospital settings, such as community and residential aged care facilities. This phenomenon presents the need for research on the career decision-making processes of final year nursing students and ways through which their career interests may be directed to the different nursing specialties to meet the healthcare demands of different client groups.

Methods: This project applied a concurrent mixed methods approach to explore how clinical placements in the final year of the Bachelor of Nursing and Graduate Entry courses impact nursing students’ career decisions. An online survey was used to collect cross-sectional data. The Career Decision Self-Efficacy Scale – Short Form was incorporated into the survey to investigate final-year nursing students’ confidence in making career decisions. Career decision-making self-efficacy refers to the confidence to complete career decision-making tasks successfully. Descriptive statistics were used to describe the participants’ characteristics. The chi-square test was used to assess the significance of the difference between categorical data, and binary logistic regression was used to determine the odds of the factors that predict career decision self-efficacy. Qualitative data was collected using semi-structured individual interviews. A narrative inquiry approach was carried out with purposively sampled final-year nursing students (n = 12) who had undertaken their final-year clinical placement(s). Qualitative data was analysed using two main steps. First, the interviews were organised and written into first-person narratives, which were then analysed using the three-dimensional framework. Subsequently, thematic analysis was applied to generate themes. The qualitative and quantitative data were analysed separately, and the findings were integrated.

Findings: The majority of participants had low confidence about making career decisions. Factors such as the setting of the final clinical placement, the intention to be employed in the specialisation or organisation of their final placement and the students’ assessment of their clinical experience were associated with career decision-making confidence. Findings of the qualitative phase identified some factors that influenced the students’ nursing specialty preferences and professional career plans. This included the students’ characteristics, such as age and gender, and the clinical environment of their final-year placements.

Conclusion: The final year of study is crucial for nursing students, as this is the time they make career plans in preparation for the transition to their professional roles. The students make short and long-term career plans that may influence their commitment to nursing. Nursing students’ career interests are influenced by a myriad of factors that are sometimes external to their nursing education, such as their ages and genders. In addition, most participants had low confidence in making career decisions. This study provides evidence for nursing stakeholders to implement measures to improve students’ confidence about making informed career decisions.

DOI

10.25958/ddgj-aj77

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