Opiniones de profesores y estudiantes de enfermería respecto al contenido de las tutorías

Enfermería Global Nº 43 Julio 2016 Página 200 DOCENCIA - INVESTIGACIÓN Opinions of nursing professors and students regarding the content of the mentoring program Opiniones de profesores y estudiantes de enfermería respecto al contenido de las tutorías *Guerra Martín, María Dolores **Lima-Serrano, Marta *Lima-Rodríguez, Joaquín Salvador *Phd. Professor Department of Nursing. School of Nursing, Physiotherapy and Podiatry. Sevilla University. E-mail: [email protected] **Phd. Doctor Assistant Professor Department of Nursing. School of Nursing, Physiotherapy and Podiatry. Sevilla University. Spain. Keywords: Nursing Education; Nursing teachers; mentorships; Nursing Students. Palabras clave: Educación en Enfermería; Docentes de Enfermería; Mentorías; Estudiantes de Enfermería ABSTRACT Objectives: To compare opinions of nursing professors and students of the University of Seville (Spain) on the themes addressed in the mentoring program, and to identify subject preferences of the students. Method: Previously validated questionnaires were given to 181 professors and 1015 students. A descriptive and bivariate analysis was conducted, supported by SPSS 18.0 (p<0.05), and for the issue of subject preferences of the students, a qualitative analysis was conducted supported by ATLAS.ti 6. Results: 56.7% female professors, mean age 46.8 years. 77.3% female students, mean age 21.4 years. Of them, 93.4% of the professors and 63.2% of the students affirmed addressing academic issues and 62.4% and 36%, respectively, addressed any subject (p<0.05), differences were observed in favour of the professors with training in mentoring (p<0.05). Those with a higher academic degree and who teach full time addressed more academic and university issues while those with a lower academic degree and teaching part time addressed the health care subjects (p<0.05). There were 868 comments on subject preferences of the students, highlighting the academic subjects (62.4%) and the professionalization subjects (18.2%). Conclusion: The sociodemographic characteristics and the professors’ prior training in mentoring influence the subject matter addressed in the mentoring program. It is important to make the opinions of these collectives known and to promote the training of the professors on this topic. Enfermería Global Nº 43 Julio 2016 Página 201 RESUMEN Objetivos: Comparar opiniones de profesores y estudiantes de enfermería de la Universidad de Sevilla (España) sobre las cuestiones abordadas en las tutorías, e identificar preferencias temáticas de los estudiantes. Método: Se aplicaron cuestionarios previamente validados a 181 profesores y 1015 estudiantes. Se realizó análisis descriptivo y bivariante apoyado en SPSS 18.0 (p<0,05) y para la pregunta sobre preferencias temáticas de los estudiantes, se realizó un análisis cualitativo apoyado en ATLAS.ti 6. Resultados: 56,7% profesoras, edad media 46,8 años. 77,3% alumnas, edad media 21,4 años. 93,4% profesores y 63,2% de estudiantes afirmaron abordar cuestiones académicas, y 62,4% y 36%, respectivamente, sobre cualquier tema (p<0,05). Se observaron diferencias favorables a los profesores con formación en tutorías (p<0,05). Los de mayor grado académico y tiempo completo abordaron más cuestiones académicas y universitarias mientras que los de menor grado académico y tiempo parcial las asistenciales (p<0,05). Hubo 868 comentarios sobre preferencias temáticas de los estudiantes, subrayando los temas académicos (62,4%) y los profesionalizantes (18,2%). Conclusión: Las características sociodemográficas y la formación previa sobre tutorías del profesorado influyen en el abordaje temático en la tutoría. Es importante dar a conocer las opiniones de estos colectivos y fomentar la formación del profesorado en este tópico. INTRODUCTION In the university context, one of the main functions of the professors is oriented towards mentoring which has to be adapted to new roles, conceptions and strategies of the teaching/learning process centred on the students, and the professor as mentor has the function of guiding, orienting and facilitating this process(1,2). Mentoring can be defined as “an orienting process, carried out jointly by the professor and the student, on academic, professional and personal aspects, with the aim of establishing a work program that favours the preparation and design of the most appropriate path for the chosen university degree” (3). Different authors have focussed their studies on the orientation that mentoring programs should have, suggesting that they should be directed towards academic, professional and personal aspects(4-6). Others from a broader view consider that they should be directed to integral -intellectual, professional and humanand social development of the university students(7,8). In the literature different empirical studies are found aimed at investigating the different aspects that are usually addressed in the mentoring programs. Among them we find those carried out in the University of Vigo (Spain)(9), in the Complutense University of Madrid (Spain)(10), in the University of Cordoba (Spain)(11), and in a University School of Antwerp (Belgium)(12), which are focussed on addressing academic subjects. In other research, such as that carried out in the University of Santiago de Compostela (Spain)(13) and in the University of Salford (United Kingdom)(14), the approach was broader, focussing on academic subjects as well as professional and personal subjects. The objectives of this paper is to compare the opinions of nursing professors and students of the University of Seville (Spain) on the issues addressed in the mentoring program, and to identify the subject preferences of the students. Enfermería Global Nº 43 Julio 2016 Página 202 METHODS The design of the research was descriptive, cross-sectional and correlational. The population studied were nursing professors and students from the School of Nursing, Physiotherapy and Podiatry of the University of Seville, and of the Nursing centres: Red Cross, San Juan de Dios and Francisco Maldonado, during the 2011/2012 school year. The population of study included 238 professors and 1299 students. In order to calculate the sample size, the MAS II program was used. For an error probability of p<0.05, a standardised distance (Z)=1.96, an error in accuracy of 0.05, and a population variance of 0.5 for finite populations, it was estimated that the sample had to be 183 professors and 484 students. Given the high number of estimated participants, it was decided to include the entire population, finally being comprised of 181 professors (76.1%) and 1015 students (78.1%). For the collection of data, two ad hoc questionnaires were designed, one for professors and another for students. These were validated by means of a panel of experts(15-17). Subsequently, a pilot study was conducted(15,18). In the final questionnaire for professors, the following sociodemographic aspects were collected: sex, age, teaching experience (considering professors with more than ten years as experts, those teaching between 5 and 10 years as consolidated and those with less than 5 years teaching experience as beginners), qualifications, academic degree, teaching centre, dedication (full, part or part time with health care dedication in the Health Institutions where the student carried out the clinical practice); course where the mentoring was carried out, and training prior to the mentoring. In the final version of the student questionnaire, the following sociodemographic aspects were compiled: sex, age, teaching centre and course in which they were enrolled. With respect to the issues addressed in the mentoring programs, six questions to professors and students were included on (a) academic issues related to the courses, (b) personal issues, (c) professionalization, that is, related to employment or their professional future, (d) care practices, (e) university organisation, and (f) any subject or consultation at the request of the students, that is, without any pre-set consultation pattern. For each of these issues, the response options were: (a) I don’t know, (b) never, (c) almost never, (d) sometimes, (e) almost always, or (f) always. The students were also asked an open question about their subject preferences to be addressed in the mentoring program. The collection of data from the professors was done by e-mail and from the students in the classroom. The study was approved by the Ethics Committee on Research of the University of Seville. Participation was voluntary and anonymous, previously requesting informed consent. The statistical package SPSS version 18.0 was used for the quantitative analysis, which was descriptive and bivariate, this latter to verify the relation between the professor and student, as well as between the sociodemographic aspects in the sample of professors and the issues addressed during the mentoring process. In order to study the relations between ordinal variables, Spearman’s Rho correlation coefficient (rs), the Mann-Whitney U test and the Kruskal-Wallis test were calculated for a p<0.05. To determine the size of the effect (coefficient of contingency or “C”, Phi or “φ”, Pearson’s “r”, and Spearman’s “rs”), the value r=0.1 was taken as low, r=0.3 as medium and r=0.5 as high value (19-21). Enfermería Global Nº 43 Julio 2016 Página 203 For the question on the subject preferences of the students, the Atlas.ti version 6 computer program was used, conducting a qualitative and categorical analysis of the textual data. For greater rigor and reliability of the analysis, this was done jointly by three evaluators, in three phases: Reduction of the information; availability or its presentation; and obtaining results and verification of conclusions(22). Six response categories were created: Academic (of the courses), personal (problems of the students), professionalization (professional future and employment market), care practice (clinical practice or practicum), university organisation (services and structure of the University of Seville) and at the request of the student (any subject requested). RESULTS Sociodemographic aspects and prior training in mentoring of the professors Of the 181 participants, 122 (67.4%) belonged to the School of Nursing, Physiotherapy and Podiatry and the rest to other teaching centres. Of the total, 56.7% (102) were women. The mean age was 46.8 (standard deviation: 8.21); 154 (85.1%) were nurses, of which 101 (55.8%) had an additional degree: 19 (10.5%) were graduates, 66 (36.5%) held master’s degrees or diplomas in advanced studies [DEA], and 16 (8.8%) were doctors. Among the professors who were not nurses, 26 were doctors and one was a university graduate. With respect to teaching experience, 75 (41.9%) were experts, 60 (33.5%) consolidated and 44 (24.6%) beginners. As for dedication, 62.4% (113) taught part time. Finally, 48 (26.7%) affirmed not having prior training in mentoring. Sociodemographic aspects of the students Of the 1015 students, among those enrolled in undergraduate studies, 360 (35.5%) were in the first year, 325 (32.0%) in the second, 314 (30.9%) in the third. Sixteen (1.6%) were studying for a master’s degree. On the other hand, 590 (58.1%) students were enrolled in the School of Nursing, Physiotherapy and Podiatry and the rest in other teaching centres. Women made up 77.3% (785) of the total, with the mean age being 21.4 years (standard deviation: 4.57). Characteristics of the mentoring program according to the perspectives of professors and students From both the viewpoint of the professors 169 (93.4%), and of the students, 641 (63%), the most addressed issues were the academic, followed by any other subject according to 113 (62.4%) of professors and 365 (36%) of students (Table 1). Table 1: Issues addressed by the professors and students in the mentoring programs. Professors Students Issues addressed Never or almost never N(%) Sometimes N(%) Always or almost always N(%) Total* Never or almost never N(%) Some - times N(%) Alway s or almost alway s N(%) Total* Academic 1 (0.6) 4 (2.2) 169 (93.4) 174 (96.2) 120 (11.8) 92 (9.1) 641 (63.2) 853 (84.0) Enfermería Global Nº 43 Julio 2016 Página 204 Personal 45 (24.9) 67 (37.0) 59 (32.6) 171 (94.5) 624 (61.5) 114 (11.2) 52 (5.1) 790 (77.8) Professional i-zation 44 (24.3) 64 (35.4) 64 (35.4) 172 (95.0) 455 (44.8) 231 (22.8) 120 (11.8) 806 (79.4) Care practice 55 (30.4) 33 (18.2) 84 (46.4) 172 (95.0) 305 (30.0) 290 (28.6) 205 (20.2) 800 (78.8) University organisation 76 (46.4) 50 (27.6) 42 (23.2) 168 (92.8) 513 (50.5) 186 (18.3) 81 (8.0) 780 (76.8) Any subject 16 (8.8) 44 (24.3) 113 (62.4) 173 (95.6) 168 (16.6) 168 (16.6) 365 (36.0) 701 (69.1) * From the total, the frequencies and percentages referring to the lost data were subtracted (DK/NA). Comparison of the opinions of professors and students Statistically significant differences in favour of the group of professors that affirmed addressing more frequently the set of the examined issues (Table 2). Table 2: Issues examined in the mentoring program by professors and students. Issues Group N Average range MannWhitney U test Asymp. Sig. Z r Academic Professors 177 633.26 53460.00 0.000 -6.28 0.20 Students 853 489.67 Personal subjects Professors 171 740.79 25001.50 0.000 -13.98 0.45 Students 801 432.21 Professionalization Professors 172 653.26 43730.00 0.000 -8.09 0.26 Students 820 463.83 Care practice Professors 172 574.78 57055.00 0.000 -4.06 0.13 Students 820 480.08 University organisation Professors 168 593.02 45608.50 0.000 -6.45 0.21 Students 780 448.97 Any subject Professors 173 514.62 47295.00 0.000 -4.62 0.16 Students 701 418.47 Relations between the sociodemographic aspects of the professors and the issues addressed in the mentoring programs Statistically significant differences were found with the academic degree. The professors with higher academic degree stated they addressed more frequently these issues: academic (rs[179]=0.23, p=0.002) and university organisation (rs[176]=0.15, p=0.017), while those with lower academic degrees affirmed higher frequency of addressing care practices (rs[179]=-0.15, p=0.043). According to qualifications, that is, being a nurse or having other degrees, a statistically significant difference was found in favour of professors with other degrees that stated in greater measure addressing academic issues or any other subject. The Enfermería Global Nº 43 Julio 2016 Página 205 professors that had received training on mentoring stated to a greater extent that they addressed academic issues and professionalization matters (Table 3). Table 3: Issues addressed according to qualifications and prior training of the professors Qualification of nurse or other degrees Issues Qualification N Average range MannWhitney U test Asymptotic Sig. Z r Academic Nurse 153 86.05 1384.50 0.003 -2.92 0.22 Other 26 113.25 Any subject Nurse 153 86.08 1390.00 0.010 -2.57 0.20 Other 26 113.04 Prior training on mentoring Academic Yes 48 106.53 2350.50 0.002 -3.1 0.23 No 131 83.94 Professionalization Yes 47 104.73 2362.50 0.015 -2.4 0.18 No 131 84.03 Relationships were found between the teaching experience and the issues addressed in the mentoring. The consolidated professors stated addressing professionalization issues, such as those related to care practices at a higher level than, at least, the beginning professors. As for the dedication of the professors, the full-time professors stated addressing academic issues at a higher level than, at least, the professors with health care work who taught part time. However, these professors stated addressing subjects related with the care practice to at a higher level than, at least, the part-time professors without health care work. Finally, as regards the courses in which the mentoring was carried out, it was found that the professors that mentored in the Master’s degree addressed professionalization issues and those related with care practices at a higher level than, at least, the professors that mentored in the first course (Table 4). Table 4: Issues addressed according to teaching experience, dedication and courses Teaching experience of the professors Issues addressed N Average range KruskalWallis gl P r Professionalization Beginners 43 71.59 7.41 2 0.025 0.14 Consolidated 59 98.05 Experts 74 90.71 Care practice Beginners 43 70.83 8.05 2 0.018 0.15 Consolidated 59 98.64 Experts 75 91.83 Dedication of the professors Academic Full time 67 104.45 18.08 2 0.000 0.22 Part time 72 89.23 Part time CIS 40 67.19 Care practice Full time 67 92.08 14.70 2 0.001 0.20 Part time 72 75.13 Part time CIS 40 113.28 Enfermería Global Nº 43 Julio 2016 Página 206 Courses where the professors mentored Professionalization First 32 72.67 10.83 4 0.029 0.12 Second 39 87.12 Third 28 90.91 Master’s 20 119.18 Care practice First 32 52.98 21.72 4 0.000 0.17 Second 39 98.77 Third 28 89.86 Master’s 20 103.10 Subject preferences to be addressed in the mentoring programs according to the students In this section, 705 students (69.3%) answered and 156 (22.2%) made more than one comment that corresponded with different categories. There were a total of 868 comments of all the courses, which were included in the different categories (Table 5). Table 5: Subject preferences of the students by courses Category 1st course N(%) 2nd course N(%) 3rd course N(%) Master’s Degree N(%) Academic 207(69.5) 169(68.7) 161(50.9) 5(62.5) Personal 18(6.0) 7(2.8) 10(3.2) 0(0.0) Professionalization 43(14.4) 40(16.3) 73(23.1) 2(25.0) Care practice 7(2.4) 8(3.2) 18(5.7) 0(0.0) University organisation 11(3.7) 11(4.5) 10(3.2) 0(0.0) At student’s request 12(4.0) 11(4.5) 44(13.9) 1(12.5) Total 298(100) 246(100) 316(100) 8(100) Thus, with respect to the academic subjects, basically comments were made on the need to clarify doubts in the mentoring, such as: “Before anything, I would like it to deal with the subjects that I don’t understand or that are difficult for me.” (stu. 245). Other comments referred to the exams, noting the importance of this question for the students: “What type of questions will be on the exam? What are the most important cases that we have to know? Subjects of great difficulty for the majority” (stu. 476). “Tricks for studying so much material. Types of questions on the exam. Highlight what is important” (stu. 520). Different students referred to using the mentoring program to get to know the evaluation and the criteria: “About the evaluation criteria” (stu. 802). “…the methodology that is being followed and others and give alternatives. I know that this is evaluated at the end of the term...” (stu. 684). Some comments were related to the use of the mentoring program in performing the work required during the degree or the Master’s program: “On the end-of-degree project” (stu. 585). “On the end of master’s degree project” (stu. 721). “Advice for the assignments that we are preparing” (stu. 155). Finally, the students highlighted the guidance on studying, concentration and academic performance techniques: “Guiding on studying (how to study,…). Academic performance (what should be improved)” (stu. 257). With respect to the personal subjects, the students made general comments, for example: “…that we could deal with personal issues and find the best help possible” (stu. 878). Comments were also made related to the feelings and other psychosocial Enfermería Global Nº 43 Julio 2016 Página 207 aspects: “Problems that arise. Doubts. Fear. Motivations. Expectations” (stu. 298). “Personal subjects with the aim of relaxing us and making us feel more secure” (stu. 408). “Self-esteem that we have with respect to the degree. Personal difficulties. Advice that stimulate us, that support us (stu. 180). On professionalization subjects, the students basically requested orientation to continue with future training: “Employment future, opportunities. Training, new studies, Master’s degree, doctorate, specialities, competitive entrance exams” (stu. 163). “That they also inform us on congresses, activities that we could carry out and they are useful for our curriculum” (stu. 480). They also made comments on the professional future, including that in other countries: “Subjects related to the employment future, job banks, competence, professional opportunities” (stu. 392), “on the possibilities and job offers in other countries” (stu. 900). Others were related to the knowledge of the labour market and of being a good professional: “I would like to be informed more on employment subjects ... Own experiences of volunteers related to the subjects studied” (stu. 411). “On how to be a good professional” (stu. 895). On care practice, the students made a series of general comments: “Subjects related to the nursing practice” (stu. 7). “I would like for the subject of the practicums to be dealt with” (stu. 507), also, related to the planning, organisation, content and evaluation of these practices: “The planning of the practicums and their evaluation” (stu. 592). “That they deal more with the practicums and explain their content” (stu. 878). To end, they made some comments on the addressing of the problems: “Problems related with the clinical practices” (stu. 640). With respect to the university organisation, the students reflected doubts in general: “…what is the work in the department, in the university, etc.” (stu. 477). “Questions related to the academic organisation and to the teaching planning...” (stu. 675). They asked for information on resources, transfers, aid and scholarships: “… inform on the different possibilities that the university offers you and the means we can use” (stu. 383). “On transfers in the university” (stu. 375). “On SENECA and ERASMUS scholarships …” (stu. 323). “Subjects related to the university itself (scholarships, aid, educational material...)” (stu. 836). Finally, the majority proposed addressing subjects on request or demand from the student according to his needs: “…that the professors ... be capable of dealing with any subject that the students brings up” (stu. 178). “Any subject that may serve us during our stay in the university” (stu. 46). “Transcendental and important subjects for the student” (stu. 692). DISCUSSION With regard to the issues addressed in the mentoring program, significant differences were observed in the responses of professors and students. Thus, considering academic matters, the professors stated a high percentage (93.4%), higher than that found in other studies(9,13), while the students stated addressing them at a lower percentage (63.2%), with values lower than those obtained by other studies(9,10). The same occurred with respect to the personal issues, where 32.6% of the professors affirmed addressing them always or nearly always, with these results coinciding with other studies(9,10,13,23). As for the studies, only 5.1% affirmed addressing personal subjects, with values lower than those obtained in other studies(10,13), despite the fact Enfermería Global Nº 43 Julio 2016 Página 208 that previous authors affirmed that the mentoring programs should serve to deal with personal aspects(3,5-7).. In relation to the professionalization issues, 35.4% of the professors affirmed addressing them always or nearly always, compared to 11.8% of the students. This low percentage of response contrasts with the results of other studies in which much higher values were obtained(13), especially if one takes into account the importance of the mentoring programs in the preparation of the students and their professional future in the labour market(3-7,24). As for the care practice, 46.4% of the professors affirmed addressing them always or nearly always, compared to 20.2% of the students, with results similar to those of other studies. The work of the healthcare nurses of the health institutions as clinical mentors(25) should be highlighted to facilitate the students achieving in situ the professional skills(24), perhaps the students address this type of issue on the care practice with these mentors and not as much with the professor participating in this study. With regard to the university organisation, 23.2% of the professors and 8% of the students stated addressing this subject, finding considerable discrepancy in the results of previous studies, with these results being lower with respect to another previous study(13). Finally, in relation to addressing the issues on any subject in the mentoring programs, in our study 62.4% of the professors affirmed dealing with them always or nearly always, compared to 36% of the students. In this regard, in another study 79.2% of the professors affirmed agreeing or completely agreeing that the mentoring programs should serve to address any problem of the students (9). With respect to the relations between the sociodemographic aspects of the sample of professors and the issues addressed in the mentoring programs, it stands out that the professors with a higher academic degree, teaching full time and with specific training in mentoring affirmed addressing at a higher level the set of issues, especially on academic matters, professionalization and university organisation. In contrast, the professors with a lower academic degree and part-time dedication to teaching and with health care work affirmed addressing with greater frequency issues on care practice. This last can be due to the fact that since these nurses work in the care area(25), the students usually go to them when they have doubts on care practices. Finally, those that had mentoring in the Master’s degree affirmed addressing more professionalization issues and on care practices, than those in Nursing undergraduate courses, and this could be due to the fact that many of these students have already entered the labour market. As for the subject preferences of the students, in first place were the academic subjects, coinciding with the subject mainly addressed in the mentoring programs, as shown from the above responses. This agreement in the results found in the two types of analysis, quantitative and qualitative, can indicate the importance that addressing the academic subjects has for the students in the mentoring programs.(9-14). In second place, they preferred the professionalization subjects, stating, therefore, the uncertainties that the students may have with regard to the professional future, with this result being coherent with the importance given by previous authors(3-7,13,24).