Dr Johanna Groothuizen
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.
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.
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.
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.
Groothuizen, J.E., Callwood, A., & Gallagher, A. (2017). What is the Value of Values Based Recruitment for Nurse Education Programmes? Journal of Advanced Nursing.