Applicants' success in the ethics entrance exam: A cross-sectional study.

BACKGROUND: Student selection is the first step in recruiting future social and healthcare professionals. Ethically competent professionals are needed in social and healthcare. It is important to select applicants who have the best possible abilities to develop their ethical competence in the future. Values-based recruitment has been used to inform the recruitment and selection of higher education applicants. However, objective and valid tests in student selection are needed. AIM: To assess social and healthcare applicants' success and related factors in the ethics section of the universities of applied sciences digital entrance examination (UAS Exam) to undergraduate degree programmes. RESEARCH DESIGN: A cross-sectional design was used. PARTICIPANTS AND RESEARCH CONTEXT: Social and healthcare applicants needed to identify ethical situations in the ethics section of a national digital entrance examination (UAS Exam) in autumn 2019 (between 29 October and 1 November) in 20 Finnish universities of applied sciences. ETHICAL CONSIDERATIONS: The process for the responsible conduct of research was followed in the study. Ethics committee approval was obtained from the Human Sciences Ethics Committee in the Satakunta region (27 September 2019). Approval to undertake the study was obtained from the participating universities of applied sciences. Participation to the study was voluntary and based on informed consent. RESULTS: The applicants' (n = 8971) mean scores were 7.1/20 (standard deviation 6.5), and 22.7% of the applicants failed the ethics section. Age, previous education, and place of birth (own/parent) explained the applicants' success in the ethics section (total score and failed exam results). CONCLUSION(S): Applicants' success in the ethics section varied indicating that future students may have a different basis to develop their ethical competence. This may impact on (new) students' learning, especially in practical studies.

Personal statement versus psychological test as admission to the nursing degree: an evaluation.

BACKGROUND: A review of admissions to nursing in Northern Ireland was prompted by the growing number of applications and a desire to ensure that the applicants had the right values for a career in nursing. Concerns regarding authorship, plagiarism and reliability of personal statements used to select applicants to interview was the focus of this research. This study evaluates the psychometric properties of a Personal Statement (PS) as a method for admission to a nursing programme and a values-based psychological screening tool, Nurse Match (NM). METHODS: A self-selecting, purposive sample (n = 228; 9.7%) was drawn from applicants to Schools of Nursing in the United Kingdom (n = 2350). Participants all of whom had completed a Personal Statement were asked to complete a psychological tool and the scoring outcomes and psychometric properties of both tests were investigated. Statistical analysis was conducted using Minitab 17. RESULTS: Applicants from 18 schools and five colleges responded. The majority (72.4%) were aged 18-19. Findings provide practical, theoretical, statistical, and qualitative reasons for concluding that the Personal Statement has substantial limitations as a measure of suitability. It does not compare well with international test standards for psychometric tests. In contrast, NM is a valid and reliable measure with good discriminatory power, standardised administration and consistent marking. CONCLUSION: NM is a viable alternative to the PS for shortlisting applicants for nursing interviews.

The "values journey" of nursing and midwifery students selected using multiple mini interviews; year two findings.

AIM: 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. BACKGROUND: 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. DESIGN: 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). METHODS: Four semi-structured focus groups were conducted. Data analysis incorporated inductive and deductive approaches in a hybrid synthesis. FINDINGS: 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." CONCLUSION: 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.

The 'values journey' of nursing and midwifery students selected using multiple mini interviews: Evaluations from a longitudinal study.

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.

The 'values journey' of nursing and midwifery students selected using multiple mini interviews; Year One findings.

AIM: To explore how adult, child and mental health nursing and midwifery students, selected using multiple mini interviews, describe their 'values journey' following exposure to the clinical practice environment. BACKGROUND: Values based recruitment (VBR) incorporates assessment of healthcare students' personal values using approaches like multiple mini interviews. Students' experience of adjustment to their values during their programme is conceptualized as a 'values journey'. The impact of VBR in alleviating erosion of personal values remains unclear. DESIGN: A cross-professional longitudinal cohort study was commenced at one university in England in 2016 with data collection points at the end of years one, two and three. Non-probability consecutive sampling resulted in 42 healthcare students (8 adult, 8 child and 9 mental health nursing and 17 midwifery students) taking part. METHODS: Six semi-structured focus groups were conducted at the end of participants' Year One (DC1). Data analysis incorporated inductive and deductive approaches in a hybrid synthesis. FINDINGS: Participants described a 'values journey' where their values, particularly communication, courage and wanting to make a difference, were both challenged and retained. Participants personal journeys also acknowledged the: 'courage it takes to use values'; 'reality of values in practice' and 'need for self-reflection on values'. CONCLUSION: A 'values journey' may begin early in a healthcare student's education programme. This is important to recognize so that appropriate interventions designed to support students in higher education and clinical practice can be implemented. The values incorporated in VBR should be continually evaluated for fitness for purpose.

What is the value of Values Based Recruitment for nurse education programmes?

AIM: A discussion of issues associated with Values Based Recruitment (VBR) for nurse education programmes. BACKGROUND: 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. DESIGN: 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 VBR in Higher Education Institutions up until June 2017 and our evaluation of the conceptualisation of VBR, 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 VBR 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 VBR methods. CONCLUSION: We call for a debate regarding the meaning and implications of VBR and further research regarding its validity and effectiveness.

Innovation in values based public health nursing student selection: A qualitative evaluation of candidate and selection panel member perspectives.

OBJECTIVES: Values based recruitment emerges from the premise that a high degree of value congruence, or the extent to which an individual's values are similar to those of the health organization in which they work, leads to organizational effectiveness. The aim of this evaluation was to explore how candidates and selection panel members experienced and perceived innovative methods of values based public health nursing student selection. DESIGN AND SAMPLE: The evaluation was framed by a qualitative exploratory design involving semi-structured interviews and a group exercise. Data were thematically analyzed. Eight semi-structured interviews were conducted with selection panel members. Twenty-two successful candidates took part in a group exercise. INTERVENTION: The use of photo elicitation interviews and situational judgment questions in the context of selection to a university-run public health nursing educational program was explored. RESULTS: While candidates were ambivalent about the use of photo elicitation interviews, with some misunderstanding the task, selection panel members saw the benefits for improving candidate expression and reducing gaming and deception. Situational interview questions were endorsed by candidates and selection panel members due to their fidelity to real-life problems and the ability of panel members to discern value congruence from candidates' responses. CONCLUSIONS: Both techniques offered innovative solutions to candidate selection for entry to the public health nursing education program.

Recruiting the next generation: applying a values-based approach to recruitment.

The qualified district nurse (DN) role demands high levels of leadership. Attracting the right candidates to apply for the Specialist Practice Qualification District Nursing (SPQDN) education programme is essential to ensure fitness to practice on qualification. Anecdotal evidence suggested that the traditional panel interview discouraged candidates from applying and a need to improve the quality of the overall interview process was identified by the authors. The University of Central Lancashire in partnership with Lancashire Care NHS Foundation Trust adopted the National Values Based Recruitment (VBR) Framework to select candidates to gain entry onto the SPQDN course. This involved using 'selection centres' of varying activities including a multiple mini interview, written exercise, group discussion, and portfolio review with scores attached to each centre. The ultimate aim of utilising VBR was to align personal and profession values to both the nursing profession and the Trust whilst allowing a fairer assessment process. An evaluation of the VBR recruitment process demonstrated 100% pass rate for the course and 100% satisfaction with the interview process reported by all 16 candidates over three academic years. Interviewer feedback showed deeper insight into the candidates' skills and values aligned with the core values and skills required by future District Nurse leaders within the Trust.

Identifying applicants suitable to a career in nursing: a value-based approach to undergraduate selection.

AIMS: The aim of this study was to complement existing evidence on the suitability of Multiple Mini Interviews as a potential tool for the selection of nursing candidates on to a BSc (Hons) nursing programme. BACKGROUND: This study aimed to trial the Multiple Mini Interview approach to recruitment with a group of first year nursing students (already selected using traditional interviews). DESIGN: Cross-sectional validation study. This paper reports on the evaluation of the participants' detailed scores from the Multiple Mini Interview stations; their original interview scores and their end of year results. METHODS: This study took place in March 2015. Scores from the seven Multiple Mini Interview stations were analysed to show the internal structure, reliability and generalizability of the stations. Original selection scores from interviews and in-course assessment were correlated with the MMI scores and variation by students' age, gender and disability status was explored. RESULTS: Reliability of the Multiple Mini Interview score was moderate (G = 0·52). The Multiple Mini Interview score provided better differentiation between more able students than did the original interview score but neither score was correlated with the module results. Multiple Mini Interview scores were positively associated with students' age but not their gender or disability status. CONCLUSION: The Multiple Mini Interview reported in this study offers a selection process that is based on the values and personal attributes regarded as desirable for a career in nursing and does not necessarily predict academic success. Its moderate reliability indicates the need for further improvement but it is capable of discriminating between candidates and shows little evidence of bias.

Recruiting for values in healthcare: a preliminary review of the evidence.

Displaying compassion, benevolence and respect, and preserving the dignity of patients are important for any healthcare professional to ensure the provision of high quality care and patient outcomes. This paper presents a structured search and thematic review of the research evidence relating to values-based recruitment within healthcare. Several different databases, journals and government reports were searched to retrieve studies relating to values-based recruitment published between 1998 and 2013, both in healthcare settings and other occupational contexts. There is limited published research related to values-based recruitment directly, so the available theoretical context of values is explored alongside an analysis of the impact of value congruence. The implications for the design of selection methods to measure values is explored beyond the scope of the initial literature search. Research suggests some selection methods may be appropriate for values-based recruitment, such as situational judgment tests (SJTs), structured interviews and multiple-mini interviews (MMIs). Personality tests were also identified as having the potential to compliment other methods (e.g. structured interviews), as part of a values-based recruitment agenda. Methods including personal statements, references and unstructured/'traditional' interviews were identified as inappropriate for values-based recruitment. Practical implications are discussed in the context of values-based recruitment in the healthcare context. Theoretical implications of our findings imply that prosocial implicit trait policies, which could be measured by selection tools such as SJTs and MMIs, may be linked to individuals' values via the behaviours individuals consider to be effective in given situations. Further research is required to state this conclusively however, and methods for values-based recruitment represent an exciting and relatively unchartered territory for further research.

Assessment of practitioners' and students' values when recruiting.

The Department of Health has tasked Health Education England with introducing values-based recruitment (VBR) for all applicants to NHS-funded healthcare programmes. This article discusses the mandate with reference to the process of VBR, how this is used in an academic setting and how it is beginning to influence appointments to all healthcare posts. The benefits and potential risks of adopting the approach are identified and recommendations for nurse managers are made.

Recruiting a Person-Centered Direct Care Workforce Through Situational Judgement Tests: A Pilot Study in the Community Support of Older People in England.

Background and Objectives: Studies have found that older people value care workers' character traits and interpersonal judgment even more highly than their technical skills. Yet identifying these traits at recruitment is challenging. This study aimed to evaluate the first situational judgement tests (STJs) for direct care workers. Research Design and Methods: Online tests were conducted with 251 care workers and members of the public in England. Participants evaluated the appropriateness of 61 potential behavioral responses to 11 "critical incidents," each depicting challenging care work scenarios. Data collection included a measure of personality traits. A subsample of 72 participants completed a second "test-retest" assessment. Results: A majority of test-takers (53%) found the test easy/very easy to complete, and most (55%) participants who worked in care reported the scenarios were highly realistic. Psychometric tests were positive. Test scores were unidimensional under a Confirmatory Factor Analysis (RMSEA = 0.038), and items broadly fit Rasch assumptions. Test-retest reliability (rho = 0.77) was acceptable, and for the general public sample, a modest increase in perceptions of the social standing of care work was observed. Test scores were positively correlated with 2 personality traits: agreeableness (r = 0.250, p < 0.001) and openness to experience (r = 0.179, p = .005). Test scores were not related to age, gender, or education level. Discussion and Implications: The findings indicate support for the use of SJTs in direct care work. Its psychometric properties appear satisfactory, and collectively give confidence in the use of SJTs for assessing the suitability of candidates during recruitment. Further research should corroborate these findings in a new sample, and examine the relationship between test scores and job performance.

Key stakeholder perspectives on expert-by-experience involvement in the values-based recruitment of student mental health nurses: A co-produced qualitative study.

BACKGROUND: Values-based recruitment is a mandatory process for nursing programmes within UK higher education, with the Nursing Midwifery Council expecting that experts-by-experience are engaged in these recruitment and selection processes. The wider involvement of experts-by-experience in healthcare education is gaining momentum internationally with calls for engagement in all aspects of design and delivery; however, the impact of such involvement in recruitment of nursing students has received little attention, particularly in mental health nursing. AIM: To understand the impact of expert-by-experience involvement in the values-based recruitment of mental health nursing students from the perspective of candidates, experts-by-experience, and academic staff. DESIGN AND METHODS: This qualitative approach was co-designed and implemented by a research team comprised of academics, experts-by-experience, and student mental health nurses. Focus groups and an on-line survey were used to collect data, with Burnard's thematic analysis providing a framework for data analysis. SETTING/PARTICIPANTS: This study took place at one UK university. Participants included nurse academics, experts-by-experience, and student nurses with experience of a values-based recruitment process. RESULTS: Thematic analysis identified four themes: starting out, collaboration, rich assessment, and stakeholder gains. Whilst not without its challenges, the involvement of experts-by-experience in the recruitment of mental health nursing students was identified as delivering a robust recruitment process, encompassing academic abilities alongside the personal qualities required to make a 'good nurse'. Personal benefits for experts-by-experience, candidates, and academics were also reported. CONCLUSION: This study provides insights into the impact of experts-by-experience in supporting values-based recruitment. The approach is identified as enhancing the selection process by drawing from academic and lived experience perspectives and highlights to potential candidates, at the outset of their career, the value of meaningful engagement. These findings support the Nursing Midwifery Council's position that experts-by-experience should be engaged in the recruitment and selection of student nurses.

Developing nurse match: A selection tool for evoking and scoring an applicant's nursing values and attributes.

AIM: To develop an instrument (Nurse Match: NM) for assessing a candidate's nursing values, their meaning, relative importance and emotional significance. Candidate's values to be scored against professionally preferred nursing values effectively and efficiently. DESIGN: A case study-based qualitative process with quantified output. Perception of self and others in relevant contexts using bi-polar value dimensions. METHODS: Respondents (N = 63) were first year nursing students completed the instrument and a feedback questionnaire. Data were analysed and scored by ipseus software using algorithm defined parameters. Statistical analysis: Minitab 17. RESULTS: The instrument discriminated effectively and efficiently between year one nurses in terms of the professional quality of their inherent nursing values and attributes;created suitability scores (STOT scores) for candidate screening purposes;suitability scores closely approximated normal distributions;was valid and reliable: robust in quantitative and qualitative terms;was administered, scored and interpreted in a standard manner;was easy to understand and complete and well received by participants. The NM instrument offers a standardized, effective, user friendly, screening process for values and attributes. Development work with a group of actual applicants is required. NM is complementary to other modes of assessment.

Service user engagement in healthcare education as a mechanism for value based recruitment: An evaluation study.

AIM: Within the United Kingdom (UK) there is an increasing focus on Values Based Recruitment (VBR) of staff working in the National Health Service (NHS) in response to public inquiries criticising the lack of person-centred care. All NHS employees are recruited on the basis of a prescribed set of values. This is extended to the recruitment of student healthcare professionals, yet there is little research of how to implement this. Involving Service Users in healthcare educational practice is gaining momentum internationally, yet involvement of service users in VBR of 'would be' healthcare professionals remains at an embryonic phase. Adult nurses represent the largest healthcare workforce in the UK, yet involvement of service users in their recruitment has received scant attention. This paper is an evaluation of the inclusion of service users in a VBR of 640 adult student nurses. BACKGROUND DESIGN: This study used a participatory mixed methods approach, with service users as co-researchers in the study. METHODS: The study consisted of mixed methods design. Quantitative data via an online questionnaire to ascertain candidates' perspectives (n=269 response rate of 42%), and academic/clinical nurses (n=35 response rate 34.65%). Qualitative data were gathered using focus groups and one to one interviews with service users (n=9). Data analysis included descriptive statistics and thematic analysis. FINDINGS: 4 overarching themes were identified; increasing sense of humanness, substantiating care values; impact of involvement; working together and making it work, a work in progress. CONCLUSION: The findings from the study highlight that involving service users in VBR of student healthcare professionals has benefits to candidates, service users and local health services. Appreciating the perceptions of healthcare professionals is fundamental in the UK and internationally to implementing service users' engagement in service enhancement and delivery. Findings from this study identify there may be a dissonance between the policy, the nurses' thoughts and their practice.

The Multiple Mini Interview for admission to nursing - male perspectives.

This article was migrated. The article was marked as recommended. Aims: The aim of this study was to gain the perspectives of men undergoing recruitment to a nursing degree programme by the process of multiple mini interviews (MMIs). Background: MMIs are used increasingly to select undergraduate students for degree courses, particularly in the healthcare sciences but the impact of MMIs on initiatives to increase gender diversity in these professions is unknown. Design: The study employed a qualitative research approach using a thematic framework of the MMI process. Methods: The study took place between January 2018 - April 2018 and a total of eight students attended for focus groups. Results: Respondents viewed the MMI process as stressful, and also reported that some of the stations created more stress than others, as they were conscious of the gender issues within some of the scenarios. Despite this they also reported the MMI to be a satisfactory selection tool. Conclusion: Participants found the use of MMIs to comprise a valid selection process which, while imperfect and female-dominated, did not unduly disadvantage male candidates. Further research involving multiple nursing schools as well as medical schools is needed to further evaluate the impact of the MMI as a selection tool on male applicants.

The reliability and validity of multiple mini interviews (MMIs) in values based recruitment to nursing, midwifery and paramedic practice programmes: Findings from an evaluation study.

BACKGROUND: Universities in the United Kingdom (UK) are required to incorporate values based recruitment (VBR) into their healthcare student selection processes. This reflects an international drive to strengthen the quality of healthcare service provision. This paper presents novel findings in relation to the reliability and predictive validity of multiple mini interviews (MMIs); one approach to VBR widely being employed by universities. OBJECTIVES: To examine the reliability (internal consistency) and predictive validity of MMIs using end of Year One practice outcomes of under-graduate pre-registration adult, child, mental health nursing, midwifery and paramedic practice students. DESIGN: Cross-discipline evaluation study. SETTING: One university in the United Kingdom. PARTICIPANTS: Data were collected in two streams: applicants to A) The September 2014 and 2015 Midwifery Studies programmes; B) September 2015 adult; Child and Mental Health Nursing and Paramedic Practice programmes. Fifty-seven midwifery students commenced their programme in 2014 and 69 in 2015; 47 and 54 agreed to participate and completed Year One respectively. 333 healthcare students commenced their programmes in September 2015. Of these, 281 agreed to participate and completed their first year (180 adult, 33 child and 34 mental health nursing and 34 paramedic practice students). METHODS: Stream A featured a seven station four-minute model with one interviewer at each station and in Stream B a six station model was employed. Cronbach's alpha was used to assess MMI station internal consistency and Pearson's moment correlation co-efficient to explore associations between participants' admission MMI score and end of Year one clinical practice outcomes (OSCE and mentor grading). RESULTS: Stream A: Significant correlations are reported between midwifery applicant's MMI scores and end of Year One practice outcomes. A multivariate linear regression model demonstrated that MMI score significantly predicted end of Year One practice outcomes controlling for age and academic entry level: coefficients 0.195 (p=0.002) and 0.116 (p=0.002) for OSCE and mentor grading respectively. In Stream B no significant correlations were found between MMI score and practice outcomes measured by mentor grading. Internal consistency for each MMI station was 'excellent' with values ranging from 0.966-0.974 across Streams A and B. CONCLUSION: This novel, cross-discipline study shows that MMIs are reliable VBR tools which have predictive validity when a seven station model is used. These data are important given the current international use of different MMI models in healthcare student selection processes.

The nurse match instrument: Exploring professional nursing identity and professional nursing values for future nurse recruitment.

From April 1st 2015 it will be mandatory for Higher Education Institutions (HEI) in the United Kingdom (UK) providing pre-qualifying health care higher education to use a Values Based Recruitment (VBR) tool, to ensure only the candidates with the "right" personal identity and values commensurate with the Professional Identity of Nursing (PIN) are accepted for nurse education. "Nurse Match" instrument was developed to enhance the recruitment and selection of candidates for pre-qualifying nursing. Action Research into PIN commenced with voluntary, purposive, convenience samples of qualified nurses (n = 30), Service Users (N = 10), postgraduate diploma nurses in mental health (N = 25), third year mental health branch students (N = 20) and adult and child student nurses in years 2 and 3 (N = 20) in Focus Groups. Data collection and analysis occurred concomitantly between July 2013 and October 2014, aided by NVivo 10 software and revealed Key Quality Indicators (KQIs) of the social construction of PIN. Construct development included a literature review spanning the last fifteen years, which identified four main themes; 1. Nursing's ethics and values. 2. Nursing's professional identity and caring. 3. Nursing's emotional intelligence. 4. Nursing's professionalism. Nurse Match offers an evidence-based enhancement to VBR, for future nurse recruitment locally, nationally and internationally.

Values-based recruitment in health care.

Values-based recruitment is a process being introduced to student selection for nursing courses and appointment to registered nurse posts. This article discusses the process of values-based recruitment and demonstrates why it is important in health care today. It examines the implications of values-based recruitment for candidates applying to nursing courses and to newly qualified nurses applying for their first posts in England. To ensure the best chance of success, candidates should understand the principles and process of values-based recruitment and how to prepare for this type of interview.