An investigation of stimuli related to baccalaureate nursing students' transition toward role mastery

As the changing health care system moves increasing numbers of nurses into independent roles in various settings including the community, nurses' ability to evaluate their own performance has become an expectation for demonstration of role mastery. Using the Roy Adaptation Model as a framework, this study investigated factors related to the baccalaureate nursing student's transition to role mastery as measured by the congruency between student's self evaluation of clinical performance and the clinical instructor's evaluation of the student. A descriptive, prospective, cross-sectional design including a triangulation of quantitative and qualitative methodologies was utilized. Student self-esteem, level in nursing school, student age, student perceived health, and student performance of secondary roles were not found to be significantly correlated to congruency between student self-evaluation and instructor evaluation of students. However, in a comparison of the subscales to each other, there was a significantly higher level of congruence between student self evaluation and instructor evaluation in the areas of Role Mastery interpersonal communication, professional development, and planning while their was a significantly lower level of agreement in the areas of critical care skills and leadership. Qualitative data revealed that nursing faculty frequently serve as role models for nursing students and that optimal student-teacher relationships were described as facilitating, nonjudgmental/ communicative, mentoring, and evaluative. Studentteacher relationships that were described as judgmental, intimidating, and noncommunicative were perceived negatively by students. Factors that students reported as having helped their progress in nursing school included constructive criticism from instructors and being treated with respect by the instructor, clinical experiences that clarified classroom theory, personal attitudes and abilities, and support of family and friends. Factors that students felt had hindered their progress included disorganized and highly critical instructors, limited clinical experience, amount of work for time available, other secondary roles, personal limitations, unclear expectations, and testing.