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Dr Johanna Groothuizen

My publications


Groothuizen Johanna, Callwood Alison, Gallagher Ann (2017) What is the value of Values Based Recruitment for nurse education programmes?, Journal of Advanced Nursing 74 (5) pp. 1068-1077 Wiley
A discussion of issues associated with Values Based Recruitment for nurse education programmes.

Values Based Recruitment is a mandatory element in selection processes of students for Higher Education healthcare courses in England, including all programmes across nursing. Students are selected on the basis that their individual values align with those presented in the Constitution of the National Health Service. However, there are issues associated with the use of values as selection criteria that have been insufficiently addressed. These are discussed.

Discussion paper.

Data Sources

This article is based on documents published on the website of the executive body responsible for the implementation of a policy regarding Values Based Recruitment in Higher Education Institutions up until June 2017 and our evaluation of the conceptualisation of Values Based Recruitment, underpinned by contemporary theory and literature.

Implications for nursing
Values Based Recruitment influences who is accepted onto a nurse education programme, but there has been limited critical evaluation regarding the effectiveness of employing values as selection criteria. Values are subject to interpretation and evidence regarding whether or how Values Based Recruitment will improve practice and care is lacking. The issues discussed in this article show that Higher Education Institutions offering nursing courses, whether in England or in other countries, should be critical and reflective regarding the implementation of Values Based Recruitment methods.

We call for a debate regarding the meaning and implications of Values Based Recruitment and further research regarding its validity and effectiveness.

Callwood Alison, Groothuizen Johanna, Allen Helen Therese (2019) The ?values journey? of nursing and midwifery students selected using multiple mini interviews; year two findings, Journal of Advanced Nursing 75 (5) pp. pp 1074-1084 Wiley


To explore how adult, child, mental health nursing and midwifery students describe their ?values journey? after completing their second year following exposure to the clinical practice environment.


Where student nurses and midwives are selected using multiple mini interviews, in a values?based recruitment process, the conservancy and or development of their personal values remains unclear.


A hermeneutic, cross?professional longitudinal study was commenced at one university in England in 2016 with data collection points at the end of years one (DC1), two (DC2) and three (DC3). From the 42 participants recruited in year one, 28 went on to participate in data collection at DC2 (3 adult, 6 child, 3 mental health nurses and 16 midwifery students).


Four semi?structured focus groups were conducted. Data analysis incorporated inductive and deductive approaches in a hybrid synthesis.


Participants did not feel their values had changed fundamentally since year one. However, the prioritization of their values and how they were ?put into practice? had changed. Key themes identified were: ?changed sense of self as a healthcare practitioner?; ?influences on values in practice? and ?reflection on values.?


Reframing of personal values is an integral part of learning across clinical and academic settings. Critical reflective practice should be integrated into pre?registration health education programmes to support student nurses and midwives sustain their learning around values; to maintain ?good? values in the face of observed ?bad? values.

Groothuizen Johanna Elise, Callwood Alison, Gallagher Ann (2018) NHS constitution values for values-based recruitment: a virtue ethics perspective, Journal of Medical Ethics 44 (8) pp. 518-523 BMJ Publishing Group
Values-based recruitment is used in England to select healthcare staff, trainees and students on the basis that their values align with those stated in the Constitution of the UK National Health Service (NHS). However, it is unclear whether the extensive body of existing literature within the field of moral philosophy was taken into account when developing these values. Although most values have a long historical tradition, a tendency to assume that they have just been invented, and to approach them uncritically, exists within the healthcare sector. Reflection is necessary. We are of the opinion that selected virtue ethics writings, which are underpinned by historical literature as well as practical analysis of the healthcare professions, provide a helpful framework for evaluation of the NHS Constitution values, to determine whether gaps exist and improvements can be made. Based on this evaluation, we argue that the definitions of certain NHS Constitution values are ambiguous. In addition to this, we argue that ?integrity' and ?practical wisdom', two important concepts in the virtue ethics literature, are not sufficiently represented within the NHS Constitution values. We believe that the NHS Constitution values could be strengthened by providing clearer definitions, and by integrating ?integrity' and ?practical wisdom'. This will benefit values-based recruitment strategies. Should healthcare policy-makers in other countries wish to develop a similar values-based recruitment framework, we advise that they proceed reflectively, and take previously published virtue ethics literature into consideration.
Groothuizen Johanna Elise, Callwood Alison, Allan Helen Therese (2019) The 'values journey' of nursing and midwifery students selected using multiple mini interviews: Evaluations from a longitudinal study, Nursing Inquiry Wiley
Values?based practice is deemed essential for healthcare provision worldwide. In England, values?based recruitment methods, such as multiple mini interviews (MMIs), are employed to ensure that healthcare students? personal values align with the values of the National Health Service (NHS), which focus on compassion and patient?centeredness. However, values cannot be seen as static constructs. They can be positively and negatively influenced by learning and socialisation. We have conceptualised students? perceptions of their values over the duration of their education programme as a ?values journey?. The aim of this hermeneutic longitudinal focus group study was to explore the ?values journey? of student nurses and midwives, recruited through MMIs, across the 3 years of their education programme. The study commenced in 2016, with 42 nursing and midwifery students, originally recruited onto their programmes through multiple mini interviews. At the third and final point of data collection, 25 participants remained. Findings indicate that students' confidence, courage and sense of accountability increased over the 3 years. However, their values were also shaped by time constraints, emotional experiences and racial discrimination. We argue that adequate psychological support is necessary as healthcare students embark on and progress through their values journey, and propose a framework for this.

In England, a Values Based Recruitment (VBR) policy intends to ensure that healthcare students? individual values align with the values of the National Health Service (NHS) Constitution. However, students? values may become compromised with increased clinical experience, due to, for instance, distress, negative role models and hidden curricula.


To explore potential differences in values between first, second, and third year students of adult nursing, in order to theorise whether and how such students? values may change over the duration of their programme, upon exposure to clinical practice environments.


1. To develop an instrument (Situational Judgement Test, SJT) that assesses students? congruence with the NHS Constitution values, and whether these are prioritised.

2. To establish whether the values (assessed using the SJT) of students with differing levels of experience (years one, two, and three ? particularly clinical practice experience) vary.

3. To generate insights into the considerations and reflections that students have regarding SJT items, and determine whether these vary between the different year groups.

4. To verify and gain a deeper understanding of these findings in the context of students? (practice) learning, as well as input for recommendations, through adult nursing Practice Liaison Tutors within the university.


This research was granted a Favourable Ethical Opinion by the University of Surrey Ethics Committee. An SJT was developed (objective 1), and reliability and validity were determined with a pilot sample of 47 volunteers. Subsequently, first (n=13), second (n=15) and third (n=9) year students (total N=37) completed the SJT and participated in discussion sessions (objectives 2 and 3). Analysis took place using inferential statistics and thematic methods. Afterwards, six tutors were presented with the findings and interviewed (objective 4).


SJT scores were highest in year one and lowest in year three (significant difference between first and third year group, F=7.28, p=.002). First year students expressed idealism. Second and third year students, however, experienced organisational hierarchy and difficulty speaking up against poor practice on their placements, at times de-prioritising the NHS Constitution values in response. Tutors could relate to these findings and suggested strategies to support students.


Despite the VBR policy, students? congruence with the NHS Constitution values may become compromised with increased clinical experience. Recommendations are made for education and placement organisations to prepare students for clinical practice, address hierarchy, and provide a safe and ethical learning environment.

Additional publications