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BACKGROUND: The desire to work in the nursing profession has recently been identified as an important aspect to consider in the selection process of nursing students but very little is known about nursing applicants' or students' desire to work in nursing. AIMS: The study aimed to describe and explain the desire of undergraduate nursing applicants to work in nursing. DESIGN: A cross-sectional study design. METHODS: The Desire to Work in Nursing Instrument was used to collect the data. All nursing applicants (N = 974) who took part in an entrance examination organised in six Universities in October 2018 were eligible to participate. Eight Hundred and Forty-one applicants (response rate 86%, 102 males) participated in the study. Statistical analysis included the use of descriptive statistics and linear regression was used to assess if dependent variables explained the observed outcomes. RESULTS: A strong desire to work in nursing was demonstrated in all the four areas. The most common reason to desire this work was suitability to nursing and the nature of work, and the least common was the career opportunities. Gender, previous education, and a realistic image best explain the desire. CONCLUSIONS: The assessment of desire to work in nursing may assist career choice of nursing applicants, and may enhance recruitment and retention in nursing education. Applicants need to be more aware of the career development possibilities. Further studies are needed to investigate if the desire to work in nursing is different to men than to women to inform recruitment strategies.

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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.

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BACKGROUND: Perceptions of the nursing profession influence career choices in nursing. An unrealistic perception might lead students to drop out of nursing education programmes. Objective measurement of the nursing applicants' perceptions at the student selection stage could enhance their career choices in nursing. AIM: To develop and psychometrically evaluate the Perception of Nursing Profession Instrument (PNPI). DESIGN: Mixed method design. METHOD: Two versions of the PNPI were developed during the years 2016-2022. The first version was based on documents describing the nursing profession and the second version was based on an integrative literature review, a focus groups study and a document analysis of descriptions of the nursing profession. The meta-ethnographic approach was used to synthesize the results and form a theoretical framework for developing the PNPI (60 items). Item content validity was evaluated by an expert panel of nurses (n = 7). The psychometric properties of the instrument were analysed using the item response theory approach. RESULTS: The development process resulted in the 40-item PNPI with the following subscales: the content of nursing work, the career in nursing, the nature of nursing work and the characteristics of a nurse. The psychometric analysis revealed unidimensionality and goodness of fit to the partial credit model; however, the item difficulty was not well matched with the participants' abilities. CONCLUSION: The PNPI is a novel instrument for objectively measuring perceptions of the nursing profession. For further development, item difficulty must be enhanced to improve the measurement accuracy of the nursing applicants' perceptions of the nursing profession. IMPACT: Perceptions of the nursing profession influence career choices, but there is a lack of objective assessment instruments that can be used in nursing student selection setting to measure the perception. The results of this study offer an instrument to measure perception, while also suggesting ideas for further development.

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Nursing applicants' desire to work in nursing has been identified as an important aspect to consider in nursing student selection, but relevant instruments are missing.To describe the development and psychometric testing of the Desire to Work in Nursing instrument.A mixed-methods design.The development phase included the collection and analysis of two types of data. First, three focus group interviews were organised with volunteer nursing applicants (n = 18) after the entrance exams of three universities of applied sciences (UAS) (in 2016). The interviews were analysed inductively. Second, scoping review data from four electronic databases were collected. Thirteen full-text articles (published between 2008 and 2019) were included in the review and analysed deductively based on the results of the focus group interviews. The items for the instrument were generated by synthesising the results of the focus group interviews and the scoping review. The testing phase included 841 nursing applicants who participated in the entrance exams of four UAS on 31 October 2018. The psychometric properties were analysed by examining internal consistency reliability and construct validity by principal component analysis (PCA).The desire to work in nursing was classified into four categories: nature of the work, career opportunities, suitability for nursing and previous experiences. The internal consistency reliability of the four subscales was satisfactory. The PCA found only one factor with an eigenvalue over one, explaining 76% of the total variance.The instrument can be considered reliable and valid. Although theoretically the instrument contains four categories, a one-factor solution should be considered in the future.Evaluation of applicants' desire to work in nursing may provide a strategy to retain students. Individuals choose the nursing profession for variety of reasons. However, there is very little understanding of why nursing applicants desire to work in nursing. With the current challenges in the adequate staffing in the nursing workforce, it is important to understand any aspects that may be associated with student recruitment and retention. In this study, it was identified that nursing applicants desire to work in nursing because of the nature of the work, career opportunities, being suitable for nursing and of previous experiences. Instrument to measure this desire was developed and tested. The tests revealed that the instrument can be used reliably in this context. It is suggested that the developed instrument could be used as a pre-screening or self-assessment tool before applying to nursing education to provide further insights to applicants about their reasons for applying and an opportunity to reflect on their decision.

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AIM: To develop an emotional intelligence (EI) test and evaluate its psychometrics for social and healthcare student selection. DESIGN: A cross-sectional methodological design. METHODS: The test was developed based on a systematic review and focus group interviews. Content validity was evaluated with expert panels, and preliminary psychometrics with two pilot studies. Descriptive statistics, correlations and item response theory were used. DATA SOURCES: Search was conducted in six databases 2018. Focus group interviews were conducted with educators and professionals in 2019. Expert panels with doctoral students, researchers and educators were conducted in 2020. Pilot tests with students were conducted 2020-2021. The developed test was administered to 4808 applicants 2021. RESULTS: The test included four subscales. Correlations support the test's theoretical structure. The items were mainly easy. CONCLUSION: The test assesses EI objectively and comprehensively. The item-level distractor analysis can be used for further test development. IMPACTS: Social care and healthcare students engage in clinical practice early in their studies, and these environments can be emotionally challenging. Assessing EI in student selection with adequate test can help the institutions of higher education to select the students with required abilities to succeed in the studies. The assessment of EI during student selection also provides information higher education institutions could use to develop and provide support interventions. The results may also encourage practice placements to include EI elements as learning objective. The results of this study and especially the use of IRT and detailed distractor analysis to evaluate the psychometric properties of EMI-T can benefit researchers and educators that develop or evaluate objective assessment tools with multiple choice questions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Emotional intelligence is important for students to enable professional interaction.

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BACKGROUND: This article aims to describe the content and the psychometric properties of emotional intelligence instruments used in health care education and to examine the relationship between emotional intelligence and study success. METHOD: Six electronic databases were searched in spring 2020. Two researchers participated in the selection and quality assessment of the articles. Ultimately, 26 articles were included in the review. RESULTS: From the included articles, 18 emotional intelligence instruments were identified. The content of the instruments focused on perception of emotions, understanding of emotions, emotional expression, managing emotions, using emotions, and social awareness and relations. In most of the studies, emotional intelligence was related to study success. CONCLUSION: The assessment of several important components of emotional intelligence was identified. Comprehensive assessment using the emotional intelligence total score seemed to be the best predictor of study success. [J Nurs Educ. 2022;61(1):6-11.].

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BACKGROUND: The assessment of reasoning skills is recommended in undergraduate nursing student selection. Reasoning skills are crucial for sound decision-making, improving patient safety and are necessary from the very beginning of studies. Nursing applicants' reasoning skills based on the reasoning process have not been previously measured. OBJECTIVES: To assess undergraduate nursing applicants' reasoning skills and factors related to them. DESIGN: A cross-sectional study. SETTING AND PARTICIPANTS: Undergraduate nursing applicants (n = 1056, response rate 55.4%), who consented to the study and performed a joint electronic entrance examination to six Finnish Universities of Applied Sciences in spring 2019, participated in the study. METHODS: The Reasoning Skills (ReSki) test, based on the steps of the reasoning process, was used, comprising three question sections (collecting information, processing information, and identifying the problem and establishing goals). Background variables were collected through a questionnaire and the Positive System Usability Scale (P-SUS). The data were analysed with descriptive statistics, Pearson correlation coefficients and analysis of covariance with Tukey's test in post-hoc multiple group comparisons. RESULTS: Applicants' total reasoning skills mean scores were above the centre of the range of possible scores (2.72/4.5, SD = 0.80). The applicants scored higher in collecting and processing information than in identifying the problem and establishing goals. Standard deviations demonstrated variance between the applicants' ability. Age, gender, and previous education were statistically significantly related to applicants' reasoning skills. Previous work experience was statistically significantly related to success only in the step of identifying the problem and establishing goals. CONCLUSIONS: Nursing applicants' reasoning skills vary in the student selection phase. Applicants are less able to identify the problem and establish goals than to collect and process information. Vocational education does not necessarily develop adequate reasoning skills and thus prepare students for higher education studies. The results have implications for educational institutions and further research.

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AIMS: To develop and psychometrically test the Reasoning Skills (ReSki) test assessing undergraduate nursing applicants' reasoning skills for student selection purposes. DESIGN: A methodological cross-sectional design was applied for the psychometric testing. METHODS: The ReSki test was developed as part of a wider electronic entrance examination. The ReSki test included a case followed by three question sections assessing nursing applicants' reasoning skills according to the reasoning process. Item response theory was used for psychometric testing to assess item discrimination, difficulty and pseudoguessing parameters. The ReSki test was taken by 1056 nursing applicants in six Finnish Universities of Applied Sciences (28 May 2019). RESULTS: In the development process, the expert evaluations indicated acceptable content validity. In the psychometric testing, the test reliability was supported by item variance, the theoretical structure was supported by the correlation coefficients and the applicant mean performance supported an acceptable overall test difficulty. The item response theory indicated variance between the items' difficulty and discrimination ranges. However, most of the wrong items failed at being functional distractors. CONCLUSION: The ReSki test is a new and valid objective assessment of undergraduate nursing applicants' reasoning skills. The item response theory provided item-level information that can be used for further development of the test, especially related to the revisions needed for the distractor items to achieve the desired level of difficulty. IMPACT: What problem did the study address? The assessment of nursing applicants' reasoning skills is suggested, but there is a lack of admission tools. What were the main findings? The results provided support for the reliability and validity of the ReSki test. Item response theory indicated the need for further item-level improvement. Where and on whom will the research have an impact? The results may benefit higher education institutions and researchers when developing a test and/or student selection processes.

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Background: Reasoning is a cognitive skill crucial to making solid decisions. The assessment of reasoning skills in nursing student selection is studied scarcely. Aim: To identify which reasoning skills should be assessed when selecting undergraduate nursing applicants. Design: A qualitative descriptive design. Methods: Four focus group interviews (n = 25) were undertaken with nursing students (n = 16) and experts (n = 9). The Clinical Reasoning Model was used as a deductive framework for the main categories. Subcategories were formed inductively. Results: All eight steps of the clinical reasoning process were deductively identified including 15 subcategories and representing reasoning skills in the selection phase: Consider the situation, Collect cues and information, Process information, Identify the problem, Establish goals, Take action, Evaluate outcomes and Reflect on the process of action and new learning. The beginning of the clinical reasoning process was emphasised most. Conclusion: The assessment of applicants' reasoning skills should focus on the information processing skills. Impact statement: This study identifies reasoning skills which should be considered in the assessment of nursing applicants.

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BACKGROUND: Emotions influence patient care decisions and professional relationships. Emotional intelligence has been proven to predict nursing students' success in clinical practice and academic performance. Scarce amount of studies have assessed the emotional intelligence in the nursing student selection context. OBJECTIVES: To assess the emotional intelligence of applicants to undergraduate (bachelor level) nursing education and the factors related to it. DESIGN: Cross-sectional quantitative study. SETTINGS: The data collection took place in four Universities of Applied Sciences in October 2016. PARTICIPANTS: Participants were nursing applicants (N = 529) who took part in the entrance exams of the four Universities. Overall, 430 applicants (response rate 81%, 75 males) gave permission to access their results for the study's purposes. METHODS: The Rankein Scale measure of emotional intelligence was used. All of the nursing applicants undertook the same electronic entrance exam in supervised computer classrooms. Statistical analysis included the use of two independent samples tests to compare differences in emotional intelligence scores and ANCOVA models to investigate whether background variables explained the observed differences. RESULTS: In this study, nursing applicants' level of emotional intelligence was found to be average (on a scale of below average, average, above average). However, total scores ranged between 102 and 160 (of 160). Approximately 4% of the applicants scored below the minimum score (<130) and therefore failed the emotional intelligence test. A statistically significant difference was found between the pass and fail groups in terms of the total score. Significant differences were also found in the three subscores and in the total score of admitted and not admitted applicants. CONCLUSIONS: Nursing applicants enter their studies with differing EI skills. This finding may have a major impact on how nursing students experience emotions during their studies. More research is needed to establish the use of EI in student selection context.

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Aim The aim of this study was to develop an evidence-based structure and content for the new nursing entrance examination. Background The purpose of the student selection process is to ensure that those admitted have the required aptitude, motivation and potential to successfully complete studies. Methods The literature reviews were collected using systematic searches in five electronic databases on the assessment of learning skills, social skills/ emotional intelligence and certainty of career choice of nursing applicants. Three focus group interviews (n = 26) were conducted. Data were analysed inductively. The structure and content of the entrance examination was formed by two data sets synthesis. Findings Nursing student selection should involve the assessment of five categories in learning skills, three in social skills and four categories in certainty of career choice. Conclusion Comprehensive assessment can ensure that those admitted are suitable for the profession and have the capability to succeed in their studies.

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AIMS AND OBJECTIVES: To explore nursing applicants' perceptions of the nursing profession and to identify the factors influencing their perceptions. BACKGROUND: Perceptions guide the career choice in nursing and the retainment in the profession. Perceptions of nursing profession are said to be outdated and unrealistic among public. Therefore, more information is needed about the perceptions of nursing applicants. DESIGN: Exploratory qualitative design using focus group interviews. METHODS: Three focus group interviews (n = 18) were conducted among applicants to undergraduate Bachelor of Science (BSc) nursing programmes. The focus group interviews were recorded transcribed and analysed using qualitative content analysis. In this study, the ethical principles set by Finnish law and the National Advisory Board on Research Ethics were followed. FINDINGS: Applicants perceived nursing through characteristics of a nurse, content of nursing work, nature of nursing work and career possibilities in nursing. According to applicants, nursing requires suitable attitude and character with knowledge, theoretical competence and good general education. Nurses were seen to work in multi-professional teams and tasks of a nurse were described through caring role of a nurse. The decision-making in nursing was regarded limited. Nursing was considered as secure job with versatile career options although the career options or the further educational possibilities were not fully recognised among applicants. Personal factors, family and friends, media and career counselling at school influenced applicants' perceptions. CONCLUSIONS: Applicants' perceptions of the nursing profession are one-sided and partly unrealistic. Future research should concentrate on planning interventions aiming to change the public image of the nursing profession.

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BACKGROUND: Although evidence-based practices are known to improve the quality of care, making it cost-efficient and improving clinical results, barriers to transferring research into clinical practice have hindered this process. AIMS: To evaluate critical care nurses' knowledge of, adherence to, and barriers toward institution-specific ventilator bundle. MATERIAL AND METHODS: In 2015, we conducted an institution-specific, cross-sectional study in a 26-bed adult mixed medical-surgical intensive care unit (ICU) in Finland using quantitative survey of knowledge and self-reported adherence with qualitative gathering of barrier data. A pre-validated multiple-choice Ventilator Bundle Questionnaire was distributed to all registered nurses who were direct care providers (n = 155). RESULTS: The final response rate was 55.5% (n = 86), and 47.2% (n = 34) of respondents had more than 10 years of ICU experience. The levels of knowledge and self-reported adherence were 71.1% and 65.8% of the total score, respectively. The level of knowledge was higher among respondents who had received in-service education about ventilator bundle compared with respondents who had not received in-service education (27.0 vs 24.0 [P = .012]). Less experienced nurses reported significantly higher adherence than nurses with more ICU experience (29.0 vs 25.0 [P = .034]). The correlation between knowledge and adherence scores was low (ρ 0.48 [P <.001]). The most well-known and adhered-to guidelines described patient positioning, daily chlorhexidine-based oral care, and strict hand hygiene. The least-known guidelines and those least adhered to described respiratory equipment, management of sedation and analgesia, and practices prior to and during endotracheal suctioning. The main barriers were related to the nurse respondents (e.g., lack of education [25.9%]), environment (e.g., role ambiguities [36.4%] and inadequate resources [21.1%]), and patients (e.g., patient discomfort [4.8%] and fear of adverse effects [4.6%]). CONCLUSIONS: Self-reported adherence did not correlate with knowledge and was not related to work experience. Most of the barriers toward evidence-based guidelines indicated a need for changes that are beyond the control of individual nurses.

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OBJECTIVES: The purpose of this integrative review was to describe young people's perceptions of the nursing profession and to identify factors influencing the perception. DESIGN: Integrative literature review. DATA SOURCES: The CINAHL, PubMed and Medic electronic databases were searched for research publications between 2006 and 2016. The keywords used were: perception, attitude, belief, view, knowledge, image, nurse, nursing care, career, profession, role, teen, middle school student, high school student, adolescent and pupil. A manual search was conducted of the reference lists of the identified articles. REVIEW METHODS: Whittemore and Knafl's method for conducting an integrative review was utilized. The quality of the chosen articles was assessed with Joanna Briggs Institute's quality appraisal tools. FINDINGS: The search resulted in eight articles. Young people described the nature of nursing work with poor working conditions, shift work and a limited level of autonomy. Nursing work was mainly seen as caring for and helping patients which was considered inferior to doctors' work. Young people did not recognize the educational requirements or the career pathways in nursing and described the status of nursing as low in society. Nurses were considered as kind and caring people who work hard and are less intellectual. The factors influencing the perception were family and relatives, friends, media, significant others and personal factors. CONCLUSIONS: Perceptions of young people do not reflect the reality of the nursing profession and the perceived image of nursing has not changed in the last ten years. Young people and the public need realistic information of the nursing profession and the actions to change the image should take place at all levels of the society. Further research is needed to understand how the perceptions of the young people can be influenced and changed to reflect a more realistic image of a contemporary nurse.

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PURPOSE: The aim of this paper was to identify and explore the literature for key aspects of uncertainty experienced by patients who have been diagnosed with breast, prostate, or colorectal cancer. ORGANIZING CONSTRUCT: Throughout the cancer journey important decisions are made about treatments, symptom control, and supportive care and many approaches have been adopted to examine coping and uncertainty associated with a cancer diagnosis. Uncertainty and its associated attributes, such as stress or anxiety, fluctuate across the disease trajectory. To appreciate the changing nature of uncertainty one should consider its effect on specific patient groups by considering the available evidence. METHODS: A comprehensive literature search that was focused on reviews and studies about uncertainty in cancer patients was conducted in PubMed and CINAHL. In total, 40 articles were identified that indicated uncertainty in patients with breast, prostate, or colorectal cancer, although the emphasis in each differed according to the nature and treatment of the disease. FINDINGS: Uncertainty was found to comprise three main themes: uncertainty because of limited or lack of information, uncertainty concerning the course and treatment choices related to the disease, and uncertainty related to everyday life and coping with the disease. CONCLUSIONS: Uncertainty influences patients' experiences of their cancer and their coping. Whilst it might be impossible to avoid uncertainty entirely, its negative effects might be ameliorated by understanding patients' specific needs along the disease trajectory of breast, prostate, and colorectal cancer.

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