UBC Theses and Dissertations

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UBC Theses and Dissertations

Participation by nurses in independent and dependent continuing learning activities Clark, Kathleen M. 1974

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PARTICIPATION BY NURSES IN INDEPENDENT AND DEPENDENT CONTINUING LEARNING ACTIVITIES by KATHLEEN M. CLARK B.Sc.N., U n i v e r s i t y of Toronto, 1966 A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS i n the F a c u l t y of. Education We accept t h i s t h e s i s as conforming to the re q u i r e d standard THE UNIVERSITY OF BRITISH COLUMBIA June 1974. I n p r e s e n t i n g t h i s t h e s i s i n p a r t i a l f u l f i l m e n t o f t h e r e q u i r e m e n t s f o r a n a d v a n c e d d e g r e e a t t h e U n i v e r s i t y o f B r i t i s h C o l u m b i a , I a g r e e t h a t t h e L i b r a r y s h a l l m a k e i t f r e e l y a v a i l a b l e f o r r e f e r e n c e a n d s t u d y . I f u r t h e r a g r e e t h a t p e r m i s s i o n f o r e x t e n s i v e c o p y i n g o f t h i s t h e s i s f o r s c h o l a r l y p u r p o s e s m a y b e g r a n t e d b y t h e H e a d o f m y D e p a r t m e n t o r b y h i s r e p r e s e n t a t i v e s . I t i s u n d e r s t o o d t h a t c o p y i n g o r p u b l i c a t i o n o f t h i s t h e s i s f o r f i n a n c i a l g a i n s h a l l n o t b e a l l o w e d w i t h o u t m y w r i t t e n p e r m i s s i o n . D e p a r t m e n t o f A d u l t E d u c a t i o n , F a c u l t y o f E d u c a t i o n T h e U n i v e r s i t y o f B r i t i s h C o l u m b i a V a n c o u v e r 8 , C a n a d a D a t e J u l y 2 4 , 1974 A B S T R A C T T h e p u r p o s e s o f t h i s s t u d y w e r e t o d e s c r i b e a n d a n a l y z e t h e p a r t i c i p a t i o n o f n u r s e s i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s , t h e i r r e a s o n s f o r e n g a g i n g i n c o n t i n u o u s l e a r n i n g , t h e i r a t t i t u d e s t o w a r d c o n t i n u i n g n u r s i n g e d u c a t i o n , a n d t h e i r s o c i o - e c o n o m i c c h a r a c t e r i s t i c s . T h e s t u d y w a s d e s i g n e d t o i n v e s t i g a t e n o t o n l y n u r s e s ' i n v o l v e m e n t i n c o n v e n t i o n a l f o r m s o f p l a n n e d s y s t e m a t i c e d u c a t i o n a l p r o g r a m s s u c h a s c o u r s e s , w o r k -s h o p s , a n d c o n f e r e n c e s ( d e p e n d e n t l e a r n i n g a c t i v i t i e s ) , b u t a l s o t h e i r a c t i v e p a r t i c i p a t i o n i n i n d i v i d u a l , s e l f - d i r e c t e d l e a r n i n g s i t u a t i o n s s u c h a s r e a d i n g , a n d l e a r n i n g p a c k a g e s ( i n d e p e n d e n t l e a r n i n g a c t i v i t i e s ) . A q u e s t i o n n a i r e w a s a d m i n i s t e r e d i n g r o u p s e s s i o n s a n d b y m a i l t o 2 2 0 r a n d o m l y s e l e c t e d f e m a l e r e g i s t e r e d n u r s e s w h o w e r e e m p l o y e d f u l l o r p a r t - t i m e b y f i v e g e n e r a l h o s p i t a l s i n t h e G r e a t e r V a n c o u v e r a r e a o f t h e p r o v i n c e o f B r i t i s h C o l u m b i a . . T h e h o s p i t a l s w e r e o f m e d i u m s i z e ( 3 0 0 - 7 0 0 b e d s ) a n d e a c h h a d a d i r e c t o r o r c o o r d i n a t o r o f i n s e r v i c e e d u c a t i o n . E a c h o f t h e r e s p o n d e n t s p a r t i c i p a t e d i n a t l e a s t o n e o f t h e c o n t i n u i n g l e a r n i n g a c t i v i t i e s a c c e s s i b l e t o n u r s e s d u r i n g t h e y e a r , S e p t e m b e r 1 , 1 9 7 2 t o S e p t e m b e r 3 0 , 1 9 7 3 , b u t o n t h e a v e r a g e , t h e g r o u p p a r t i c i p a t i o n r a t e w a s l e s s t h a n h a l f t h e t o t a l p o s s i b l e s c o r e . N o n e t h e -l e s s , i t w a s e s t a b l i s h e d t h a t t h e r e s p o n d e n t s e n g a g e d i n s i g n i f i c a n t l y m o r e i n d e p e n d e n t t h a n d e p e n d e n t l e a r n i n g a c t i v i t i e s . A f a c t o r a n a l y s i s o f S . B . S h e f f i e l d ' s L e a r n i n g O r i e n t a t i o n I n d e x d e t e r m i n e d t h a t t h i s p a r t i c u l a r g r o u p o f n u r s e s d i d p o s s e s s t h e t h r e e b a s i c l e a r n i n g o r i e n t a t i o n s d e s c r i b e d b y C . 0 . H o u l e b u t t h a t t h e i r i i r e a s o n s f o r p a r t i c i p a t i n g i n c o n t i n u o u s l e a r n i n g c o u l d b e m o r e p r e c i s e l y d e f i n e d a s b e i n g l e a r n i n g , o c c u p a t i o n a l , p r o f e s s i o n a l , s o c i e t a l , s o c i a -b i l i t y , i n t e r a c t i v e , a n d r e l i e f f r o m b o r e d o m a n d f r u s t r a t i o n - o r i e n t e d . I n a d d i t i o n , t h e r e s p o n d e n t s w e r e f o u n d t o h a v e a f a v o u r a b l e a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n w h i c h r e l a t e d s i g n i f i c a n t l y t o t h e i r p a r t i c i p a t i o n s c o r e s . O t h e r f a c t o r s r e l a t e d t o t h e n u r s e s ' p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s i n c l u d e d t h e p s y c h o l o g i c a l v a r i a b l e s - L e a r n i n g , S o c i a b i l i t y , P r o f e s s i o n a l , a n d I n t e r a c t i v e O r i e n t a t i o n , a s w e l l a s t h e f o l l o w i n g s o c i o - e c o n o m i c c h a r a c t e r i s t i c s : n u m b e r o f p r e s c h o o l c h i l d r e n , u n i v e r s i t y e d u c a t i o n a l e x p e r i e n c e , p o s i t i o n , e m p l o y m e n t s t a t u s , a n d l e n g t h o f c u r r e n t e m p l o y m e n t . A s a r e s u l t o f m u l t i p l e r e g r e s s i o n a n a l y s e s , t h r e e o f t h e l e a r n i n g o r i e n t a t i o n s a n d t h e a t t i t u d e o f n u r s e s t o w a r d c o n -t i n u i n g n u r s i n g e d u c a t i o n w e r e f o u n d t o b e b e t t e r p r e d i c t o r s o f t h e r e s p o n d e n t s p a r t i c i p a t i o n s c o r e s t h a n w e r e c e r t a i n s o c i o - e c o n o m i c f a c t o r s . T h e f a v o u r a b i l i t y o f n u r s e s ' a t t i t u d e s t o w a r d c o n t i n u i n g n u r s i n g e d u c a t i o n e m e r g e d a s t h e m o s t e f f i c i e n t s i n g l e p r e d i c t o r . ' ACKNOWLEDGEMENTS I n i t i a l l y , I would like to acknowledge the support and direction of the members of my thesis committee, Dr. J. G. Dickinson, Dr. J. E. Thornton, and Ms. E. S. Rothwell, R.N., and the financial support received from W. K. Kellogg Foundation project. In.addition, I have appreciated the interest and encouragement of Dr. Coolie Verner and Ms. M. Neylan, R.N. I would l i k e to thank the Directors of Nursing of Burnaby General Hospital, Lion's Gate Hospital, Royal Columbian Hospital, St. Paul's Hospital, and Surrey Memorial Hospital for permitting me to conduct my study in these five agencies. I would also l i k e to thank the members of the nursing staff of those hospitals who volunteered to complete the survey questionnaire. My appreciation extends to my fellow students in adult education; the post-basic degree students at the School of Nursing, University of British Columbia; the nursing staff at the Health Sciences Centre Hospital -Department of Psychiatry, University of British Columbia; and the fifteen continuing nursing educators who helped me develop and revise the question-naire. I am indebted to Sherman B. Sheffield for granting me permission to use his Learning Orientation Index and to A. Blunt, J. Halm, and Dr. J. B. Collins for assisting me with the analysis of the data. Finally, I would like to take this opportunity to express my sincere gratitude to Malcolm, my family, and a few special friends for their continued moral support. iv TABLE OF CONTENTS Page ABSTRACT i i ACKNOWLEDGEMENTS iv LIST OF TABLES ix CHAPTER I INTRODUCTION 1 THE PROBLEM 2 PURPOSES 3 HYPOTHESES 5 DEFINITION OF 'TERMS 6 SIGNIFICANCE ; 7 ORGANIZATION OF THE STUDY . . . . . 8 CHAPTER II REVIEW OF THE LITERATURE 9 PARTICIPATION 1 0 The Extent of Participation 1 0 The Nature of Participation 1 2 LEARNING ORIENTATIONS 1 3 Identification of Learning Orientations 1 5 Relationship of Learning Orientations and Extent of Participation 1 6 v v i Page A T T I T U D E T O W A R D C O N T I N U I N G N U R S I N G E D U C A T I O N 17 S O C I O - E C O N O M I C F A C T O R S 1 9 S U M M A R Y 2 3 C H A P T E R I I I M E T H O D O L O G Y 2 5 P O P U L A T I O N 2 5 S A M P L E 2 8 D E V E L O P M E N T O F T H E I N S T R U M E N T 2 9 P a r t i c i p a t i o n I n d e x ' 2 9 A t t i t u d e S c a l e 3 1 L e a r n i n g O r i e n t a t i o n I n d e x 3 3 B i o g r a p h i c a l I n f o r m a t i o n . 3 3 P R E T E S T O F T H E I N S T R U M E N T 3 5 D A T A C O L L E C T I O N A N D D E S C R I P T I O N : O F T H E S A M P L E 3 5 D A T A A N A L Y S I S 37 C h a r a c t e r i s t i c s o f t h e S a m p l e 37 T e s t i n g t h e H y p o t h e s e s 3 8 L I M I T A T I O N S 4 0 S U M M A R Y 4 0 C H A P T E R I V F I N D I N G S 4 1 S O C I O - E C O N O M I C C H A R A C T E R I S T I C S O F T H E S A M P L E 4 1 A g e a n d M a r i t a l S t a t u s 4 1 N u m b e r o f C h i l d r e n 4 2 v i i Page Educational Background 4 6 Years of Nursing Practice 4 6 Length of Current Employment 4 7 Employment Status and Position 47 C l i n i c a l Specialty 4 8 Discussion 4 9 PARTICIPATION IN CONTINUING LEARNING ACTIVITIES 5 1 Total Participation 5 1 Independent Learning Ac t i v i t i e s 5 2 Dependent Learning Activities 5 2 Difference Between Participation in Independent and Dependent Activities 5 2 Description of Participation in Each Learning Activity . . . 5 3 ORIENTATIONS TO CONTINUOUS LEARNING 5 8 Learning Orientation 6 2 Sociability Orientation . . . . 6 3 Occupational Orientation 64 Professional Orientation 6 5 Societal Orientation 65 Interactive Orientation 6 6 Relief from Boredom and Frustration Orientation 67 Discussion 67 ATTITUDE TOWARD CONTINUING NURSING EDUCATION 69 v i i i Page RELATIONSHIPS BETWEEN PSYCHOLOGICAL AND SOCIO-ECONOMIC FACTORS AND EXTENT AND NATURE OF PARTICIPATION 7 0 Number of Preschool Children 7 4 Educational Preparation 74 Length of Current Employment 75 Employment Status 75 Position 7 6 PREDICTORS OF EXTENT AND NATURE OF PARTICIPATION 7 6 Discussion 8 0 SUMMARY 8 1 CHAPTER V SUMMARY, CONCLUSIONS AND IMPLICATIONS . . 8 2 SUMMARY 8 3 Methodology , 8 4 Findings 8 5 CONCLUSIONS 8 9 IMPLICATIONS FOR CONTINUING NURSING EDUCATION 9 3 REFERENCES 9 9 APPENDIX A Letter of enquiry to Directors of Nursing 1 0 4 APPENDIX B Letter to potential respondents 1 0 5 APPENDIX C Continuing Education Questionnaire for Registered Nurses 106 APPENDIX D Factor Loadings on Eight Factors and Communalities Resulting from Principle Components Analysis with Varimax Rotation of Data from Learning Orientation Index 1 1 8 APPENDIX E Distribution of Scores on Learning Orientation Index Statements 1 2 4 LIST OF TABLES Table Page 1 Number and Percentage D i s t r i b u t i o n of R e g i s t e r e d Nurses Employed i n the F i v e H o s p i t a l s 2 8 2 Summary Table of Socio-Economic C h a r a c t e r i s t i c s of Respondents ( I n t e r v a l Data) . . . . . . . 4 3 3 Summary Table of Socio-Economic C h a r a c t e r i s t i c s of Respondents (Nominal Data) . 4 4 4 P a r t i c i p a t i o n i n Continuing Learning A c t i v i t i e s f o r Nurses 5 1 5 Percentage D i s t r i b u t i o n of P a r t i c i p a t i o n i n Continuing Learning A c t i v i t i e s 54 6 Learning O r i e n t a t i o n F a c t o r s and Percentage of Variance i n the Data Accounted For 5 9 7 S h e f f i e l d ' s Learning O r i e n t a t i o n F a c t o r s and Percentage of Variance i n the Data A c c o u n t e d For 6 0 8 Sovie's Learning O r i e n t a t i o n F a c t o r s and Percentage of Variance i n the Data Accounted For 6 1 9 C o r r e l a t i o n s Between P a r t i c i p a t i o n and Selected Independent V a r i a b l e s 7 1 1 0 R e s u l t s of Regression Analyses 78 1 1 C o r r e l a t i o n C o e f f i c i e n t s F o r V a r i a b l e s Found t o Account For Variance i n P a r t i c i p a t i o n Scores ( T o t a l , Independent and Dependent A c t i v i t i e s ) 7 9 i x C H A P T E R I I N T R O D U C T I O N T h e n e e d f o r c o n t i n u o u s l e a r n i n g a n d t h e p r e c i p i t a t i n g f o r c e s o f s o c i a l c h a n g e a n d o c c u p a t i o n a l o b s o l e s c e n c e h a v e b e e n r e p e a t e d l y d o c u -m e n t e d ( 2 0 , 1 9 , 1 5 ) . L i f e - l o n g l e a r n i n g i s p e r t i n e n t t o a l l s o c i e t a l g r o u p s b u t h a s b e e n i d e n t i f i e d a s p a r t i c u l a r l y r e l e v a n t t o t h e v a r i o u s h e a l t h p r o f e s s i o n s . I n c r e a s i n g c o n c e r n i s b e i n g e x p r e s s e d a b o u t t h e q u a l i t y o f h e a l t h c a r e a n d t h e m a i n t e n a n c e o f p r o f e s s i o n a l c o m p e t e n c e . T h i s c o n c e r n i s s h a r e d b y t h e c o n s u m e r s o f h e a l t h c a r e s e r v i c e s , g o v e r n -m e n t s , a n d t h e p r o f e s s i o n s t h e m s e l v e s . T h e r e s p o n s e t o t h i s c o n c e r n h a s b e e n a g e n e r a l d e m a n d f o r t h e c o n t i n u i n g e d u c a t i o n o f a l l h e a l t h p r a c t i -t i o n e r s a n d i n s o m e c a s e s t h e e n a c t m e n t o f l e g i s l a t i o n t o r e q u i r e c e r t a i n p r o f e s s i o n a l g r o u p s t o p a r t i c i p a t e i n e d u c a t i o n a l a c t i v i t i e s i n o r d e r t o r e t a i n t h e i r l i c e n s u r e , r e g i s t r a t i o n , o r c e r t i f i c a t i o n ( 2 2 , 3 0 ) . T h e n u r s i n g p r o f e s s i o n , a s t h e l a r g e s t s i n g l e g r o u p o f h e a l t h p r a c t i t i o n e r s , h a s b e e n m a r k e d l y i n f l u e n c e d b y t h e v a s t c h a n g e s i n t h e k n o w l e d g e a n d t e c h n o l o g y o f h e a l t h c a r e . N e w c o n c e p t s a n d p r a c t i c e s h a v e c h a l l e n g e d n u r s e s ' a b i l i t i e s t o m a i n t a i n t h e i r p r o f e s s i o n a l c o m p e t e n c e . A l t h o u g h s o m e w h a t s l o w t o a c k n o w l e d g e t h e n e e d t o u p d a t e i t s m e m b e r s s y s t e m a t i c a l l y , t h e n u r s i n g p r o f e s s i o n n o w a f f i r m s t h e c o n c e p t o f c o n t i n -u o u s l e a r n i n g ( 1 5 ) . T h i s c o m m i t m e n t t o c o n t i n u i n g n u r s i n g e d u c a t i o n i s r e f l e c t e d i n 1 2 the development and p r o l i f e r a t i o n of a v a r i e t y of o p p o r t u n i t i e s for l e a r n -ing that are formal and i n f o r m a l , c r e d i t and n o n - c r e d i t , i n d i v i d u a l as w e l l as group-or i en ted . To date , the p r o f e s s i o n ' s a t t e n t i o n and a c t i v i t y has been d i r e c t e d to the p lanning and implementation of d i f f e r e n t k inds of cont inuing education programs. Most of these programs are being made a v a i l a b l e under the sponsorship of education i n s t i t u t i o n s such as u n i v e r -s i t i e s and community co l l eges as w e l l as hea l th care agencies and nurs ing a s s o c i a t i o n s . The programs are u s u a l l y n o n - c r e d i t , short - term and or i ented to group l e a r n i n g . Only r e c e n t l y has c o n s i d e r a t i o n been given to the need to evaluate and study the var ious components of cont inuing nurs ing educat ion and t h e i r impact on nurs ing and the d e l i v e r y of h e a l t h c a r e . While some nurses are addressing themselves to the fundamental quest ion of whether cont inu ing nurs ing educat ion i n f a c t improves the q u a l i t y of h e a l t h c a r e , others are attempting to examine s y s t e m a t i c a l l y the nature of those educat iona l a c t i v -i t i e s c u r r e n t l y being o f fered and the future needs of t h e i r co l leagues ( 33,21,31)' A few s tudies have a l so been done on the p a r t i c i p a t i o n of nurses i n cont inu ing education and some of the f a c t o r s thought to be r e -l a t e d to p a r t i c i p a t i o n have been i n v e s t i g a t e d (14,37,5,4 ) . THE PROBLEM In a review of the l i t e r a t u r e from 1960-1970, Nakamoto and Verner concluded that l i t t l e research of v a l i d and r e l i a b l e consequence has been done i n r e l a t i o n to cont inu ing nurs ing education (31 ) . Most references 3 t e n d t o b e d e s c r i p t i v e a n d r e f l e c t a l a c k o f c o n s e n s u s e v e n a s t o t h e d e f i n i t i o n o f c o n t i n u i n g n u r s i n g e d u c a t i o n . I t i s n o w e v i d e n t t h a t w h a t h a s e v o l v e d i s a v a s t a r r a y o f u n r e l a t e d , u n c o o r d i n a t e d , a n d o f t e n i r r e l e v a n t e d u c a t i o n a l a c t i v i t i e s f o r n u r s e s w h o i n m a n y c a s e s h a v e n o t y e t a c c e p t e d t h e r e s p o n s i b i l i t y f o r m a i n t a i n i n g t h e i r o w n p r o f e s s i o n a l c o m p e t e n c e . A l t h o u g h c o n s i d e r a b l e s p e c u l a t i o n a n d s o m e s t u d y h a s b e e n f o c u s e d o n f a c t o r s d e t e r r i n g n u r s e s f r o m e n g a g i n g i n c o n t i n u o u s l e a r n i n g , l i t t l e i s k n o w n a b o u t w h a t p r o m p t s n u r s e s t o p a r t i c i p a t e i n e d u c a t i o n a l a c t i v i t i e s a n d w h a t f o r m t h a t p a r t i c i p a t i o n t a k e s . S k e p t i c a l o b s e r v e r s a r e m o v e d t o c o n c l u d e t h a t n u r s e s g e n e r a l l y h a v e a n e g a t i v e a t t i t u d e t o c o n t i n u i n g e d u c a t i o n a n d t h a t t h e y w i l l n o t e n g a g e i n l e a r n i n g i n o r d e r t o s u s t a i n a d e s i r a b l e s t a n d a r d o f p r o f e s s i o n a l p e r f o r m a n c e u n l e s s r e q u i r e d t o d o s o . T h i s s t u d y . a d d r e s s e s i t s e l f t o s o m e o f t h e s e i s s u e s b y s e e k i n g a n s w e r s t o t h e f o l l o w i n g q u e s t i o n s : W h a t i s t h e e x t e n t a n d n a t u r e o f n u r s e s ' p a r t i c i p a t i o n i n c o n t i n u i n g n u r s i n g e d u c a t i o n ? W h a t a r e t h e r e a s o n s f o r t h e i r p a r t i c i p a t i o n ? W h a t a t t i t u d e s d o n u r s e s h a v e t o w a r d c o n t i n u i n g t h e i r l e a r n i n g ? A n d , h o w i s n u r s e s ' p a r t i c i p a t i o n i n c o n t i n -u i n g e d u c a t i o n a f f e c t e d b y c e r t a i n m o t i v a t i o n a l , a t t i t u d i n a l a n d s o c i o -e c o n o m i c f a c t o r s ? P U R P O S E S I n o r d e r t o c o n t r i b u t e t o t h e r a t i o n a l p l a n n i n g a n d d e v e l o p m e n t o f c o n t i n u i n g n u r s i n g e d u c a t i o n i n B r i t i s h C o l u m b i a , t h e s t u d y s p e c i f i c a l l y 4 . e x p l o r e s t h e e x t e n t o f p a r t i c i p a t i o n b y r e g i s t e r e d n u r s e s i n s e l e c t e d t y p e s o f c o n t i n u i n g n u r s i n g l e a r n i n g a c t i v i t i e s . I t i s e x p e c t e d t h a t n u r s e s l i k e m o s t o t h e r a d u l t l e a r n e r s p a r t i c i p a t e i n i n d e p e n d e n t , s e l f -d i r e c t e d k i n d s o f l e a r n i n g t o a n e v e n g r e a t e r e x t e n t t h a n i n e d u c a t i o n a l p r o g r a m s p l a n n e d a n d d i r e c t e d b y a t e a c h e r , i n s t r u c t o r o r r e s o u r c e p e r s o n ( 2 6 , 4 0 ) . T h e s c o p e o f t h e s t u d y p e r m i t s a p r e l i m i n a r y d e s c r i p t i o n o f n u r s e s ' p a r t i c i p a t i o n i n a v a r i e t y o f l e a r n i n g a c t i v i t i e s a n d d o e s n o t r e s t r i c t i t s e l f t o a l i m i t e d r a n g e o f s y s t e m a t i c a l l y p l a n n e d a n d g u i d e d e d u c a t i o n a l e v e n t s . I n a d d i t i o n t o p r o v i d i n g i n f o r m a t i o n a b o u t n u r s e s ' p a r t i c i p a t i o n i n c o n t i n u o u s l e a r n i n g a c t i v i t i e s , t h e s t u d y s e e k s t o a s c e r t a i n c e r t a i n p s y c h o l o g i c a l a n d s o c i o - e c o n o m i c c h a r a c t e r i s t i c s o f t h e p a r t i c i p a n t s t h e m s e l v e s . L e a r n e r s ' m o t i v a t i o n s o r r e a s o n s f o r p a r t i c i p a t i n g i n c o n t i n -u o u s l e a r n i n g h a v e b e e n i d e n t i f i e d a s r e l e v a n t f a c t o r s a b o u t w h i c h v e r y l i t t l e i s k n o w n i n r e l a t i o n t o n u r s e s . B a s e d u p o n t h e w o r k o f H o u l e , S h e f f i e l d a n d S o v i e , t h e s t u d y s e e k s t o i d e n t i f y n u r s e s ' b a s i c l e a r n i n g o r i e n t a t i o n s ( 2 5 , 3 6 , 37 ) . N u r s e s ' a t t i t u d e s t o c o n t i n u i n g n u r s i n g e d u c a t i o n a r e a n o t h e r p e r t i n e n t p s y c h o l o g i c a l v a r i a b l e . I n a s m u c h a s n o p r e v i o u s r e s e a r c h h a s s y s t e m a t i c a l l y i n v e s t i g a t e d t h i s p a r t i c u l a r p a r t i c i p a n t c h a r a c t e r i s t i c , t h e r e s e a r c h o f A d o p h a n d W h a l e y w i t h a d u l t e d u c a t o r s w a s . a d a p t e d f o r t h e p u r p o s e o f d e t e r m i n i n g t h e f a v o u r a b i l i t y o f n u r s e s ' a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n ( 1 ) . . T e n s o c i o - e c o n o m i c f a c t o r s w e r e i d e n t i f i e d f o r t h e p u r p o s e s o f d e s c r i b i n g t h e c h a r a c t e r i s t i c s o f p a r t i c i p a n t n u r s e s i n B r i t i s h C o l u m b i a . T h e s e i n v o l v e d a g e , m a r i t a l s t a t u s , n u m b e r o f c h i l d r e n , e d u c a t i o n a l 5 b a c k g r o u n d , y e a r s s i n c e g r a d u a t i o n , y e a r s o f a c t i v e a n d i n a c t i v e p r a c t i c e , l e n g t h o f c u r r e n t e m p l o y m e n t , e m p l o y m e n t s t a t u s a n d p o s i t i o n . R e s e a r c h s u g g e s t s t h a t t h e t w o p s y c h o l o g i c a l v a r i a b l e s ( a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n a n d r e a s o n s f o r p a r t i c i p a t i o n ) a n d a f e w o f t h e s o c i o - e c o n o m i c v a r i a b l e s a r e r e l a t e d t o p a r t i c i p a t i o n i n c o n t i n u o u s l e a r n i n g a n d t h a t t h e y m a y s i n g l y o r i n c o m b i n a t i o n p r e d i c t a n i n d i v i d u a l ' s l e v e l o f p a r t i c i p a t i o n . T h e s e r e l a t i o n s h i p s a r e e x a m i n e d i n t h i s s t u d y w i t h r e f e r e n c e t o a p o p u l a t i o n o f r e g i s t e r e d n u r s e s i n t h e G r e a t e r V a n c o u v e r a r e a o f B r i t i s h C o l u m b i a . H Y P O T H E S E S O n t h e b a s i s o f t h e p r e v i o u s l y s t a t e d p u r p o s e s a n d t h e e v i d e n c e s u m m a r i z e d i n C h a p t e r I I , t h e f o l l o w i n g h y p o t h e s e s w e r e f o r m u l a t e d f o r t h i s s t u d y : 1 . R e g i s t e r e d n u r s e s p a r t i c i p a t e m o r e i n i n d e p e n d e n t t h a n i n d e p e n d e n t l e a r n i n g a c t i v i t i e s . 2 . R e g i s t e r e d n u r s e s p o s s e s s t h r e e b a s i c l e a r n i n g o r i e n t a t i o n s w h i c h m a y b e d e s c r i b e d a s g o a l , a c t i v i t y a n d l e a r n i n g - o r i e n t e d . 3 . T h e l e a r n i n g o r i e n t a t i o n s d i s p l a y e d b y r e g i s t e r e d n u r s e s w i l l b e r e l a t e d t o t h e e x t e n t a n d t y p e o f p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s . 4 . T h e m o r e f a v o u r a b l e t h e a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n , t h e g r e a t e r r e g i s t e r e d n u r s e s ' t o t a l p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s . 5 . P a r t i c i p a t i o n b y r e g i s t e r e d n u r s e s i n c o n t i n u i n g l e a r n i n g a c t i v -i t i e s i s r e l a t e d t o c e r t a i n s o c i o - e c o n o m i c c h a r a c t e r i s t i c s . 6 . T h e l e a r n i n g o r i e n t a t i o n s a n d a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n w i l l b e b e t t e r p r e d i c t o r s o f p a r t i c i p a t i o n b y r e g i s t e r e d n u r s e s i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s t h a n w i l l s e l e c t e d s o c i o -e c o n o m i c f a c t o r s . D E F I N I T I O N O F T E R M S F o r t h e p u r p o s e s o f t h i s s t u d y t h e f o l l o w i n g t e r m s w e r e d e f i n e d : R e g i s t e r e d n u r s e - a n u r s e w h o h o l d s a c u r r e n t p r a c t i c i n g m e m b e r s h i p i n t h e R e g i s t e r e d N u r s e s ' A s s o c i a t i o n o f B r i t i s h C o l u m b i a a n d w h o m e e t s c e r t a i n r e q u i r e m e n t s a s d e t e r m i n e d b y t h e B o a r d o f D i r e c t o r s , R . N . A . B . C . t h e r e b y r e c e i v i n g a c e r t i f i c a t e o f r e g i s t r a t i o n w h i c h e n t i t l e s h e r t o u s e t h e t i t l e o f ' R e g i s t e r e d N u r s e ' o r ' R . N . ' . C o n t i n u i n g l e a r n i n g a c t i v i t y f o r n u r s e s - a n y a c t i v i t y u n d e r t a k e n a l o n e o r w i t h o t h e r s w h e r e t h e p r i n c i p a l i n t e n t i s t o b r i n g a b o u t c h a n g e s i n i n f o r m a t i o n , k n o w l e d g e , u n d e r s t a n d i n g , s k i l l s , a p p r e c i a t i o n a n d a t t i t u d e s w h i c h w i l l m a i n t a i n o r i m p r o v e p r o f e s s i o n a l c o m p e t e n c e ( 3 7 ) • I n d e p e n d e n t a c t i v i t y - n o o n e e x t e r n a l t o t h e l e a r n e r i s p r e s e n t t o p l a n a n d m a n a g e t h e l e a r n i n g p r o c e s s , t h e r e f o r e , l e a r n i n g i s s e l f - p l a n n e d a n d s e l f - m a n a g e d . 7 D e p e n d e n t a c t i v i t y - t h e a c t i v i t y i s c o n d u c t e d i n t h e p r e s e n c e o f s o m e o n e e x t e r n a l t o t h e l e a r n e r ( s ) w h o p l a n s a n d m a n a g e s t h e l e a r n i n g p r o c e s s . L e a r n i n g o r i e n t a t i o n - t h e m a j o r p r i n c i p l e w h i c h g i v e s m e a n i n g o r d i r e c t i o n t o t h e c o n t i n u i n g l e a r n i n g a c t o r p r o c e s s u n d e r t a k e n b y t h e a d u l t l e a r n e r ( 3 6 ) . A t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n - a s i n g l e m e a s u r e o f r e g i s t e r e d n u r s e s ' a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n a s r e f l e c t e d i n t h e r e s p o n s e t o a n a t t i t u d e s c a l e . SIGNIFICANCE T h e d e v e l o p m e n t a n d i m p l e m e n t a t i o n o f r e l e v a n t a n d e f f e c t i v e c o n t i n u i n g e d u c a t i o n i n n u r s i n g i s d e p e n d e n t u p o n t h e e s t a b l i s h m e n t o f a s o u n d r a t i o n a l e f o r s u c h a c t i v i t i e s . E f f e c t i v e a n d e f f i c i e n t p r o g r a m p l a n n i n g f o r i n d i v i d u a l n u r s e s a n d g r o u p s a l s o r e q u i r e s c o n s i d e r a b l e k n o w l e d g e a n d e x p e r t i s e . A s t u d y o f t h e p a r t i c i p a t i o n o f n u r s e s i n s e l e c t e d c o n t i n u o u s l e a r n i n g a c t i v i t i e s a n d t h e i n f l u e n c e o f c e r t a i n p a r t i c i p a n t c h a r a c t e r i s t i c s o n t h a t i n v o l v e m e n t w i l l c o n t r i b u t e t o t h a t n e c e s s a r y b o d y o f k n o w l e d g e a n d e x p e r t i s e . S p e c i f i c a l l y , t h e e x t e n t t o w h i c h n u r s e s e n g a g e i n i n d e p e n d e n t a c t i v i t i e s m o r e t h a n d e p e n d e n t a c t i v i t i e s h a s d e f i n i t e i m p o r t f o r t h e d e s i g n o f e d u c a t i o n a l e v e n t s a n d t h e p r e p a r a t i o n a n d d i s t r i b u t i o n o f r e s o u r c e s . I t m a y a l s o h a v e s e r i o u s i m p l i c a t i o n s w i t h r e g a r d t o t h e i s s u e o f m a n d a t o r y c o n t i n u i n g e d u c a t i o n b e i n g a c o n d i t i o n f o r t h e r e n e w a l of l i c e n s u r e . O r i e n t a t i o n s to continuous l e a r n i n g and a t t i t u d e to c o n t i n -uing n u r s i n g education i n p a r t i c u l a r are c r i t i c a l f a c t o r s to be considered when planning an e d u c a t i o n a l event. S p e c i f i c l e a r n i n g needs may w e l l be i n f e r r e d from t h i s study that would suggest p o s s i b l e d i r e c t i o n s f o r f u t u r e programming i n the province. ORGANIZATION OF THE STUDY The l i t e r a t u r e r e l e v a n t to nurses' p a r t i c i p a t i o n i n c o n t i n u i n g education and p s y c h o l o g i c a l and socio-economic c h a r a c t e r i s t i c s i n f l u e n c i n g p a r t i c i p a t i o n i s reviewed i n Chapter I I . The methodology f o r the develop-ment and implementation of the study i s des c r i b e d i n Chapter I I I . Chapter IV r e p o r t s and i n t e r p r e t s the r e s u l t s obtained, and Chapter V i n c l u d e s the summary, c o n c l u s i o n s , and i m p l i c a t i o n s f o r the f u t u r e development of con-t i n u i n g education f o r nurses. CHAPTER II REVIEW OF THE LITERATURE While the professional literature in the health sciences abounds with philosophical and descriptive material, there has been l i t t l e sub-stantive research done that i s relevant to the present study. A few recent studies identified in the nursing literature indicate a beginning awareness of the need to establish a more knowledgable and rational base for the development of continuing nursing education. Price, Flaherty, and Barter and Ruane have initiated research into identifying the needs of nurses for continuous learning ( 3 3 , 2 1 , 3 ). Others, notably Cooper and Hornback, Bennet, Bevis, Sovie, and Berg, have taken the approach of study-ing nurses' participation in continuing education a c t i v i t i e s as a way of determining the patterns of nurses' educational activity ( 1 4 , 4 , 6 , 3 7 , 5 ) . Several of these studies also report findings related to certain psycho-logical and socio-economic factors that characterize either participant or non-participant in continuing nursing education programs. This review w i l l essentially focus on those studies in the nursing literature that relate specifically to the extent and nature of nurses' participation in continuous learning, their reasons for doing so, the attitudes they hold toward continuing their education and certain identi-fied personal characteristics such as age, educational preparation and 9 e m p l o y m e n t s t a t u s . N a k a m o t o a n d V e r n e r ' s c o m p r e h e n s i v e r e v i e w o f t h e l i t e r a t u r e f r o m 1 9 6 0 - 1 9 7 0 w i l l b e u s e d w i t h a d d i t i o n a l d i s c u s s i o n o f m o r e r e c e n t w o r k . F r e q u e n t r e f e r e n c e w i l l a l s o b e m a d e t o t h e m o r e a b u n d a n t l i t e r a t u r e e m a n a t i n g f r o m t h e g e n e r a l f i e l d o f a d u l t e d u c a t i o n . T h i s r e s e a r c h h a s c o n t r i b u t e d t o t h e d e v e l o p m e n t o f k n o w l e d g e a n d e x p e r -t i s e i n t h e m o r e s p e c i a l i z e d a r e a o f n u r s i n g e d u c a t i o n a n d p r o v i d e s s o m e u s e f u l m o d e l s f o r r e s e a r c h d e s i g n a n d m e t h o d o l o g y . P A R T I C I P A T I O N M u c h o f t h e e a r l y r e s e a r c h i n a d u l t e d u c a t i o n d e a l t w i t h t h e p a r t i c i p a t i o n o f l e a r n e r s i n v a r i o u s e d u c a t i o n a l p r o g r a m s . F r o m t h e s o m e w h a t l i m i t e d a p p r o a c h o f d e s c r i b i n g t h e a c t o f p a r t i c i p a t i o n , t h e p e r s p e c t i v e h a s a p p r o p r i a t e l y e x p a n d e d t o a m o r e c o m p r e h e n s i v e s t u d y o f t h e e x t e n t a n d n a t u r e o f p a r t i c i p a t i o n , t h e c h a r a c t e r i s t i c s o f t h e p a r t i c -i p a n t s t h e m s e l v e s a n d o t h e r r e l a t e d f a c t o r s . T h e E x t e n t o f P a r t i c i p a t i o n T h e m o s t f r e q u e n t l y c i t e d s t u d y o f t h e e d u c a t i o n a l p u r s u i t s o f a d u l t s i n t h e U n i t e d S t a t e s e s t i m a t e d t h a t a p p r o x i m a t e l y 2 5 m i l l i o n A m e r i c a n a d u l t s h a d b e e n a c t i v e i n o n e o r a n o t h e r f o r m o f l e a r n i n g i n 1 9 6 2 ( 2 6 ) . A m o r e r e c e n t n a t i o n a l s t u d y c o n d u c t e d j o i n t l y b y t h e U . S . O f f i c e o f E d u c a t i o n a n d t h e B u r e a u o f t h e C e n s u s r e p o r t e d t h a t f o r t h e y e a r e n d i n g M a y 1 9 6 9 , 1 0 . 1 % o f t h e e s t i m a t e d U . S . p o p u l a t i o n o f 1 3 0 , 3 1 4 , 0 0 0 p e r s o n s a g e s e v e n t e e n a n d o v e r w e r e i n v o l v e d i n a d u l t e d u c a t i o n ( 3 2 ) . A l t h o u g h t h i s s u g g e s t s a d e c r e a s e i n t h e r a t e o f p a r t i c i p a t i o n , t h e d i f f e r e n c e c a n l i k e l y t o a t t r i b u t e d t o t h e m o r e s t r i c t c r i t e r i a f o r d a t a c o l l e c t i o n u s e d i n t h e s e c o n d s t u d y . I n t h i s p r o j e c t , a l l p e r s o n s e n g a g e d i n f u l l - t i m e s t u d y w e r e e l i m i n a t e d f r o m t h e s a m p l e . T h e n u m b e r o f n u r s e s w h o p a r t i c i p a t e i n c o n t i n u i n g e d u c a t i o n i s d i f f i c u l t t o e s t i m a t e b e c a u s e o f a l a c k o f d a t a u p o n w h i c h t o b a s e p r o j e c -t i o n s . I n o r d e r t o p r o v i d e s o m e i n d i c a t i o n o f t h e e x t e n t o f p a r t i c i p a t i o n b y n u r s e s i n c o n t i n u i n g e d u c a t i o n , N a k a m o t o a n d V e r n e r u s e d a s t a t i s t i c f r o m C u r t i s s e t a l , C o n t i n u i n g E d u c a t i o n i n N u r s i n g ( 1 7 ) . A p p l y i n g t h e m e m b e r s h i p i n t h e A m e r i c a n N u r s e s ' A s s o c i a t i o n a s a c r i t e r i o n , a n a t i o n a l e s t i m a t e o f l e s s t h a n 3 0 p e r c e n t w a s m a d e , b u t " t h e n u m b e r o f n u r s e s a w a r e o f t h e i r n e e d s f o r f u r t h e r s t u d y a r e t o b e f o u n d i n e n c o u r a g i n g n u m b e r s " ( 3 1 ) • A p a r a l l e l e s t i m a t e o n t h e b a s i s o f C a n a d i a n n u r s e s ' m e m b e r s h i p i n t h e n a t i o n a l o r p r o v i n c i a l p r o f e s s i o n a l a s s o c i a t i o n s c a n n o t b e m a d e d u e t o t h e m i x e d v o l u n t a r y - c o m p l u s o r y n a t u r e o f m e m b e r s h i p r e q u i r e m e n t s a c r o s s t h e c o u n t r y . I n B r i t i s h C o l u m b i a , a r e c e n t a t t e m p t w a s m a d e t o a s s e s s t h e d e g r e e o f p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n b y v a r i o u s h e a l t h c a r e p e r s o n n e l , i n c l u d i n g n u r s e s ( 1 8 ) . A c a s u a l s u r v e y w a s m a d e o f t h e n u m b e r o f r e g i s -t r a n t s i n t h e e d u c a t i o n a l p r o g r a m s o f f o u r h e a l t h c a r e o r g a n i z a t i o n s . E v e n t h o u g h t h e d a t a c o l l e c t e d s u g g e s t t h a t p a r t i c i p a t i o n i s i n c r e a s i n g , t h e i n a d e q u a t e s y s t e m o f r e c o r d i n g s u c h i n f o r m a t i o n b y t h e s e i n s t i t u t i o n s i n -v a l i d a t e s a n y c o n c l u s i o n s . W h i l e t h e e x t e n t t o w h i c h n u r s e s e n g a g e i n c o n t i n u i n g e d u c a t i o n m a y i n d e e d b e i n c r e a s i n g , i t i s n o t y e t j u d g e d t o b e a d e q u a t e t o e n s u r e a s a t i s f a c t o r y l e v e l o f p r o f e s s i o n a l c o m p e t e n c e ( 4, 3 0 ) . R e s e a r c h i n t o t h e n e e d f o r c o n t i n u i n g e d u c a t i o n f o r n u r s e s i n O n t a r i o r e v e a l e d t h a t t h e m a j o r i t y o f n u r s e s i n t h a t p r o v i n c e a r e n o t a c t i v e l y e n g a g e d i n c o n t i n u i n g e d u c a t i o n ( 2 1 ) . I t w a s r e p o r t e d t h a t a p p r o x i m a t e l y t w o - t h i r d s o f t h e m h a d n o t u s e d e x i s t i n g e d u c a t i o n a l r e s o u r c e s s i n c e t h e i r g r a d u a t i o n f r o m b a s i c n u r s i n g e d u c a t i o n p r o g r a m s . T h e N a t u r e o f P a r t i c i p a t i o n M u c h o f t h e a l a r m a b o u t t h e a p p a r e n t l a c k o f n u r s e i n v o l v e m e n t i n c o n t i n u o u s l e a r n i n g m a y w e l l b e j u s t i f i e d . N e v e r t h e l e s s , i t i s i m p o r t a n t t o n o t e t h a t i n m o s t i n s t a n c e s , t h e c r i t i c s b o t h f r o m w i t h i n a n d w i t h o u t t h e p r o f e s s i o n , t e n d t o s p e a k f r o m a s o m e w h a t l i m i t e d c o n c e p t i o n o f c o n -t i n u i n g n u r s i n g e d u c a t i o n . F o r m a n y , c o n t i n u i n g e d u c a t i o n f o r n u r s e s e n -c o m p a s s e s o n l y c e r t a i n k i n d s o f p l a n n e d s y s t e m a t i c a p p r o a c h e s t o l e a r n i n g s u c h a s s h o r t c o u r s e s , w o r k s h o p s , c o n f e r e n c e s , a n d i n s o m e c a s e s f o r m a l a c a d e m i c c r e d i t p r o g r a m s . P e r h a p s i t i s s i m p l y a m a t t e r o f c o n v e n i e n c e , b u t p a r t i c i p a t i o n s t u d i e s s u c h a s C o o p e r a n d H o r n b a c k ' s t e n d t o f o c u s p r i m a r i l y o n g r o u p - o r i e n t e d e d u c a t i o n a l p r o g r a m s w h i c h a r e p l a n n e d a n d d i r e c t e d b y s o m e o n e o t h e r t h a n t h e l e a r n e r f u n c t i o n i n g a s a t e a c h e r , i n s t r u c t o r o r r e s o u r c e p e r s o n . O n l y v e r y r e c e n t l y h a s r e c o g n i t i o n b e e n g i v e n i n t h e n u r s i n g l i t -e r a t u r e t o t h e o c c u r r e n c e a n d i m p o r t o f i n d i v i d u a l a n d i n d e p e n d e n t m o d e s o f l e a r n i n g ( 2 4 , 3 9 , 1 3 , 2 9 ) . N o k n o w n r e s e a r c h h a s s p e c i f i c a l l y i n v e s t i g a t e d t h e e x t e n t o f l e a r n i n g e n g a g e d i n b y n u r s e s o n t h e i r o w n w i t h o u t t h e g u i d a n c e o f a n i n s t r u c t o r . S o m e s t u d i e s ( 2 1 , 3 7 , 6 , 4 ) , h a v e c o l l e c t e d d a t a r e l e v a n t t o i n d e p e n d e n t l y - o r i e n t e d l e a r n i n g a c t i v i t i e s s u c h a s r e a d i n g b u t t h e s e d o n o t s p e c i f i c a l l y d i s c r i m i n a t e b e t w e e n w h a t t h e p r e s e n t s t u d y i d e n t i f i e s a s i n d e p e n d e n t a n d d e p e n d e n t t y p e s o f c o n t i n -u o u s l e a r n i n g . C e r t a i n l y n o c o m p a r i s o n w a s m a d e b e t w e e n t h e e x t e n t o f n u r s e s ' p a r t i c i p a t i o n i n s e l f - d i r e c t e d a n d o t h e r - d i r e c t e d a c t i v i t i e s . S t u d i e s i n a d u l t e d u c a t i o n g e n e r a l l y s u g g e s t t h a t t h e i n c i d e n c e o f i n d e p e n d e n t l e a r n i n g o n t h e p a r t o f a d u l t s i s c o n s i d e r a b l e a n d m e r i t s p a r t i c u l a r a t t e n t i o n . J o h n s t o n e a n d R i v e r a r e p o r t e d a p p r o x i m a t e l y n i n e m i l l i o n p a r t i c i p a n t s i n i n d e p e n d e n t s t u d y ( 2 6 ) . H o u l e a n d T o u g h i n t h e i r a n a l y s e s o f t h e c h a r a c t e r i s t i c s a n d a c t i v i t i e s o f t h e ' i n d e p e n d e n t l e a r n e r ' b o t h s p e a k t o t h e p r e v e l a n c e o f s e l f - d i r e c t e d l e a r n i n g t o t h e e x t e n t t h a t T o u g h s t a t e s t h a t " p r o b a b l y e v e r y . . . a d u l t s o m e t i m e s e n g a g e s i n s e l f - t e a c h i n g , t h o u g h s o m e d o s o o n l y r a r e l y a n d b r i e f l y " ( 4 0 ) . L E A R N I N G O R I E N T A T I O N S I n T h e I n q u i r i n g M i n d , C O . H o u l e s t r e s s e d t h e i m p o r t a n c e o f s t u d y i n g t h e p a r t i c i p a n t a s w e l l a s t h e a c t o f p a r t i c i p a t i o n ( 2 5 ) . O n e o f t h e p a r t i c i p a n t c h a r a c t e r i s t i c s t h o u g h t t o b e a s i g n i f i c a n t d e t e r m i n a n t o f a d u l t e d u c a t i o n p r o g r a m p l a n n i n g , c u r r i c u l a a n d i n s t r u c t i o n a l t e c h n i q u e s i s t h e m o t i v a t i o n a l f a c t o r . C o n s i d e r a b l e r e s e a r c h h a s b e e n c o n d u c t e d i n t o w h y s o m e a d u l t s a p p e a r t o : b e c o n t i n u i n g l e a r n e r s w h i l e o t h e r s a r e n o t ( 1 0 9 ) . B u r g e s s a c c o u n t s f o r a n d p r o v i d e s e x a m p l e s o f f o u r d i f f e r e n t a p p r o a c h e s t o d e t e r m i n i n g r e a s o n s f o r p a r t i c i p a t i o n i n c o n t i n u o u s l e a r n i n g 14 a c t i v i t i e s ( 1 0 ) . He c i t e s t h e J o h n s t o n e a n d R i v e r a s t u d y a s o n e e x -a m p l e o f a n a l y z i n g t h e k i n d s o f a c t i v i t i e s i n w h i c h t h e a d u l t ( l e a r n e r ) p a r t i c i p a t e s s o t h a t r e a s o n s c a n b e i n f e r r e d f r o m t h o s e a c t i v i t i e s . A s e c o n d a p p r o a c h i n v o l v e s a s k i n g t h e l e a r n e r t o s t a t e i n h i s o w n w o r d s w h y h e p a r t i c i p a t e s i n a g i v e n a c t i v i t y . T h e r e c e n t i n v e s t i g a t i o n s o f T o u g h e x e m p l i f y t h e t h i r d m e t h o d w h i c h u s e s a p r e d e t e r m i n e d l i s t o f r e a s o n s f o r p a r t i c i p a n t s t o i n d i c a t e t h e i r m o t i v e s f o r l e a r n i n g ( 4 1 ) . I n t h e m o r e s p e c i a l i z e d l i t e r a t u r e p e r t a i n i n g t o c o n t i n u i n g n u r s i n g e d u c a t i o n , F l a h e r t y u s e d t h e l i s t a p p r o a c h w h e n s h e a s k e d O n t a r i o n u r s e s t o i n d i c a t e w h i c h o n e o f s e v e n f a c t o r s w a s m o s t l i k e l y t o m o t i v a t e ( t h e i r ) e n r o l l m e n t i n a n e d u c a t i o n a l p r o g r a m r e l a t e d d i r e c t l y t o n u r s i n g ( 2 1 ) . T h e d e s i r e f o r i n c r e a s e d p r o f e s s i o n a l c o m p e t e n c e a n d t h e a c q u i s i t i o n o f s p e c i a l i s t s k i l l s e m e r g e d a s t w o common r e a s o n s . T h e a p p r o a c h a d o p t e d b y B u r g e s s i n h i s o w n r e s e a r c h a n d t h e o n e u s e d i n t h e p r e s e n t s t u d y c o n c e n t r a t e s o n t h e a d u l t ' s o r i e n t a t i o n t o w a r d e d u c a t i o n . H o u l e w a s t h e f i r s t t o p r o p o s e t h a t a d u l t c o n t i n u i n g l e a r n e r s h a d t h e s a m e b a s i c w a y s o f t h i n k i n g a b o u t t h e i r i n v o l v e m e n t i n l e a r n i n g b u t t h a t t h e y t e n d e d t o v a r y a s t o t h e i r p r e d o m i n e n t c o n c e p t i o n o r o r i e n -t a t i o n . He d e f i n e d t h r e e f u n d a m e n t a l o r i e n t a t i o n s a s f o l l o w s : " T h e g o a l - o r i e n t e d ( l e a r n e r s ) a r e t h o s e w h o u s e e d u c a t i o n a s a m e a n s o f a c c o m p l i s h i n g f a i r l y c l e a r - c u t o b j e c t i v e s . T h e . . . a c t i v i t y - o r i e n t e d ( l e a r n e r s ) a r e t h o s e who t a k e p a r t b e c a u s e t h e y f i n d i n t h e c i r c u m -s t a n c e s o f t h e l e a r n i n g a m e a n i n g w h i c h h a s n o n e c e s -s a r y c o n n e c t i o n a n d o f t e n n o c o n n e c t i o n a t a l l , w i t h t h e c o n t e n t o r t h e a n n o u n c e d p u r p o s e s o f t h e a c t i v i t y . T h e l e a r n i n g - o r i e n t e d ( l e a r n e r s ) s e e k k n o w l e d g e f o r i t s o w n s a k e " ( 2 5 ) . 15 I d e n t i f i c a t i o n o f L e a r n i n g O r i e n t a t i o n s U s i n g t h e s e c o n c e p t s a s a b a s i s , S h e f f i e l d s t u d i e d t h e l e a r n i n g o r i e n t a t i o n s o f a d u l t p a r t i c i p a n t s i n f o u r e s s e n t i a l l y d i f f e r e n t k i n d s o f c o n f e r e n c e s h e l d a t u n i v e r s i t i e s l o c a t e d i n d i v e r s e g e o g r a p h i c a l a r e a s i n t h e U n i t e d S t a t e s . T h e s t u d y t e s t e d t h e a p p l i c a b i l i t y o f H o u l e ' s t y p o l o g y t o a d u l t l e a r n e r s l e s s i n v o l v e d i n t h e c o n t i n u i n g l e a r n i n g p r o -c e s s . S h e f f i e l d d e v e l o p e d a v a l i d a n d r e l i a b l e 5 8 i t e m L e a r n i n g O r i e n -t a t i o n I n d e x , t h e r e s p o n s e s t o w h i c h w e r e s u b j e c t e d t o f a c t o r a n a l y s i s b y K a i s e r ' s v a r i m a x c r i t e r i o n i n o r d e r t o i d e n t i f y t h e s i m p l e s t r u c t u r e o f t h e d a t a . T h e r e s u l t s c o n f i r m e d t h e e x i s t e n c e o f l e a r n i n g o r i e n t a t i o n s a n d e x t e n d e d H o u l e ' s t y p o l o g y b y p r o v i d i n g t w o a d d i t i o n a l o r i e n t a t i o n s . S h e f f i e l d ' s a n a l y s i s d e m o n s t r a t e d f i v e c o n t i n u i n g l e a r n i n g o r i e n t a t i o n s w h i c h h e c a l l e d t h e l e a r n i n g , d e s i r e - f o r - s o c i a b i l i t y , p e r s o n a l - g o a l , s o c i e t a l - g o a l a n d n e e d - f u l f i l l m e n t o r i e n t a t i o n . I n a s t u d y f o c u s s i n g o n a n u r s i n g p o p u l a t i o n , S o v i e s o u g h t t o i d e n t i f y t h e l e a r n i n g o r i e n t a t i o n s a n d p a t t e r n s o f n u r s i n g a n d c o n t i n u i n g e d u c a t i o n a c t i v i t y o f p r a c t i c i n g s t a f f n u r s e s ( 3 7 ) . U s i n g a m o d i f i e d v e r s i o n o f S h e f f i e l d ' s L e a r n i n g O r i e n t a t i o n I n d e x a n d s i m i l a r a n a l y s i s p r o c e d u r e s , S o v i e w a s a b l e t o i d e n t i f y e i g h t p a t t e r n s o f l e a r n i n g o r i e n -t a t i o n w h i c h w e r e c o n s i s t e n t w i t h H o u l e ' s o r i g i n a l a n d S h e f f i e l d ' s s u b s e -q u e n t d e f i n i t i o n s . T h e l e a r n i n g o r i e n t a t i o n a g a i n e m e r g e d a s a d i s t i n c t p a t t e r n . T h e g o a l o r i e n t a t i o n d i v i d e d i n t o t h e f o l l o w i n g s u b - t y p e s ; p e r s o n a l - g o a l , o c c u p a t i o n a l - g o a l , p r o f e s s i o n a l - g o a l , a n d s o c i e t a l - g o a l . T h e a c t i v i t y o r i e n t a t i o n d i v i d e d i n t o t w o m a j o r p a t t e r n s - s o c i a b i l i t y 16 a n d n e e d - f u l f i l l m e n t , w h i l e t h e s o c i a b i l i t y o r i e n t a t i o n f u r t h e r s u b d i v i d e d i n t o p e r s o n a l - s o c i a b i l i t y a n d p r o f e s s i o n a l - s o c i a b i l i t y . R e l a t i o n s h i p o f L e a r n i n g O r i e n t a t i o n s a n d E x t e n t o f P a r t i c i p a t i o n A f t e r i d e n t i f y i n g t h e l e a r n i n g o r i e n t a t i o n s o f t h e i r p a r t i c u l a r s a m p l e s , b o t h S h e f f i e l d a n d S o v i e p r o c e e d e d t o e x a m i n e t h e r e l a t i o n s h i p b e t w e e n t h e o r i e n t a t i o n s a n d a m e a s u r e o f t h e e x t e n t o f p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n . S h e f f i e l d c o n s t r u c t e d a s u r v e y i n s t r u m e n t t h a t m e a s u r e d t h e d e g r e e o f p a r t i c i p a t i o n i n a b r o a d s p e c t r u m o f i n f o r m a l a n d f o r m a l c o n t i n u i n g l e a r n i n g a c t i v i t i e s . H e r e p o r t e d t h a t w h i l e t h e l e a r n i n g a n d p e r s o n a l - g o a l o r i e n t a t i o n s b o t h c o r r e l a t e d p o s i t i v e l y a n d s i g n i f i c a n t l y w i t h t h e e x t e n t o f p a r t i c i p a t i o n , t h e o t h e r t h r e e w e r e n o t s i g n i f i c a n t l y c o r r e l a t e d w i t h t h e l e v e l o f i n v o l v e m e n t i n c o n t i n u i n g l e a r n i n g . S o v i e c o m b i n e d t h e r e s p o n s e s o n t w o i n s t r u m e n t s t o m e a s u r e t h e t o t a l e d u c a t i o n a l a c t i v i t y o f n u r s e p a r t i c i p a n t s a n d p o t e n t i a l p a r t i c i p a n t s . B e v i s ' J o b A c t i v i t y S u r v e y p r o v i d e d a n i n d i c a t i o n o f e d u c a t i o n a l a c t i v i t y o n t h e j o b w h i l e L i t c h f i e l d ' s L e i s u r e A c t i v i t y S u r v e y w a s u s e d t o d e t e r m i n e l e i s u r e t i m e p a r t i c i p a t i o n i n c o n t i n u i n g e d u c a t i o n a c t i v i t i e s . S o v i e c o n c l u d e d t h a t t h e r e w e r e s i g n i f i c a n t i n t e r r e l a t i o n s h i p s b e t w e e n t h e l e a r n i n g , p e r s o n a l -s o c i a b i l i t y , o c c u p a t i o n a l - g o a l , s o c i e t a l - g o a l a n d p e r s o n a l - g o a l o r i e n t a t i o n s a n d t o t a l e d u c a t i o n a l a c t i v i t y ( 37 ) . W h i l e t h e s t u d i e s d e s c r i b e d p r e v i o u s l y l o o k e d a t p a r t i c i p a t i o n i n a w i d e v a r i e t y o f c o n t i n u i n g l e a r n i n g a c t i v i t i e s , t h e y d i d n o t a t t e m p t t o q u e s t i o n t h e r e l a t i o n s h i p o f i d e n t i f i e d l e a r n i n g o r i e n t a t i o n s t o s p e c i f i c k i n d s o f e d u c a t i o n a l a c t i v i t i e s . I t w o u l d t h e r e f o r e a p p e a r t o b e u s e f u l t o i d e n t i f y t h e l e a r n i n g o r i e n t a t i o n s o f n u r s e s a n d t o a n a l y z e t h e e m e r -g e n t o r i e n t a t i o n s i n r e l a t i o n t o p a r t i c u l a r t y p e s o f c o n t i n u i n g n u r s i n g l e a r n i n g a c t i v i t i e s . F o r p u r p o s e s o f t h i s s t u d y , t h e t y p e s o f l e a r n i n g a c t i v i t i e s a r e c l a s s i f i e d a s d e p e n d e n t a n d i n d e p e n d e n t . I t w o u l d b e r e a s o n a b l e t o e x p e c t t h a t t h o s e n u r s e s w h o a r e p r e d o m i n a n t l y a c t i v i t y o r i e n t e d w o u l d t e n d t o e n g a g e m o r e i n d e p e n d e n t t y p e l e a r n i n g a c t i v i t i e s w h e r e o p p o r t u n i t i e s p e r m i t s o c i a l c o n t a c t a n d t h e f u l f i l l m e n t o f n e e d s o t h e r t h a n l e a r n i n g f o r i t s o w n s a k e o r l e a r n i n g t o a c h i e v e s o m e s p e c i f i c g o a l o r o b j e c t i v e . I t i s u n l i k e l y t h a t a n y p a r t i c u l a r r e l a t i o n s h i p w o u l d e x i s t b e t w e e n t h e e x t e n t o f p a r t i c i p a t i o n i n t h e t w o k i n d s o f a c t i v i t i e s a n d l e a r n i n g o r g o a l o r i e n t a t i o n s . N u r s e s c o u l d p r e s u m a b l y s a t i s f y b o t h m o t i v a t i o n a l p a t t e r n s e q u a l l y w e l l i n e i t h e r t y p e o f l e a r n i n g s i t u a t i o n . A T T I T U D E T O W A R D C O N T I N U I N G N U R S I N G E D U C A T I O N T h e n a t u r e o f n u r s e s ' a t t i t u d e s t o w a r d c o n t i n u i n g t h e i r p r o f e s -s i o n a l e d u c a t i o n h a s b e e n i d e n t i f i e d a s a p e r t i n e n t v a r i a b l e t o m e a s u r e i n t h e p r e s e n t s t u d y . I t s r e l a t i o n s h i p t o t h e e x t e n t o f p a r t i c i p a t i o n w o u l d , a s s u g g e s t e d p r e v i o u s l y , i n f l u e n c e t h e d i r e c t i o n a n d d e v e l o p m e n t o f c o n t i n u i n g n u r s i n g e d u c a t i o n . A c c o r d i n g t o B r u n n e r i t i s " i m p o r t a n t t o r e a l i z e t h a t a t t i t u d e s a s d y n a m i c p s y c h o l o g i c a l f a c t o r s d e t e r m i n i n g v a r i o u s r e s p o n s e a c t i v i t i e s , i . e . a s ' r e a d i n e s s f o r r e s p o n s e ' , a r e i n v o l v e d i n a l l l e a r n i n g s i t u a t i o n s " ( 9 ) . T h e y a r e l e a r n e d r e s p o n s e s w h i c h m a y i n f l u e n c e f u r t h e r l e a r n i n g . A s s u c h t h e y s e r v e a s m o t i v a t i o n a l f o r c e s . A t t i t u d e s h a v e a n a f f e c t i v e a s w e l l a s a c o g n i t i v e d i m e n s i o n . T h e i r p o s i t i v e - n e g a t i v e , o r f a v o u r a b l e -u n f a v o u r a b l e a t t r i b u t e s i m p l y t h e i r g o a l - d i r e c t e d n a t u r e ( 9 ) . 18 Brunner accounts for a considerable amount of research done in relation to attitudes and the implications for adult education. None-theless, a review of the adult education and nursing literature did not unearth any studies uniquely pertinent to the questions posed in the present investigation. Adolph and Whaley's research into the "relative degree of favourable or unfavourable attitudes toward adult education among selected groups of participants in adult education programs", how-ever, was used as an approach to the problem of attitude measurement. Their instrument was a Thurstone type scale constructed in four phases. A large number of statements (164) expressing various attitudes toward adult education were edited and subjected to a judging procedure. Forty members of an introductory course in adult education were asked to assign a number from one to nine to each statement using the following as a guide: One represents an extremely unfavourable statement Five- represents a neutral statement, and Nine represents an extremely favourable statement. The accumulated frequency of the assigned scale values for each statement was then plotted on a graph against the scale value range (1-9). The exact scale value and the Q-value (inter-quartile range) were determined from the graph and approximately one-third of the items eliminated using the Q-value as an objective criterion of ambiguity. A f i n a l reduction in the number of statements was achieved by a selection process using the scale value, Q-value, relevance and content as c r i t e r i a . The f i n a l twenty-four statements ranged from 1.3 to 8.6 on the scale. The r e l i a b i l i t y of the scale was determined by the split-halves technique (r = .692). The Spearman-Brown formula established the r e l i a b i l i t y of the whole test (r = .818). The inclusion of a graphic self-rating scale in the question-naire permitted a limited test of va l i d i t y in that the coefficient of cor-relation between the self-rating scale scores and the actual scores was r = .794. Unfortunately Adolph and Whaley's findings do not contribute to an increased understanding of nurses' attitudes toward continuing education but their instrument does provide a measure that could be adopted for a similar study with a nursing population. SOCIO-ECONOMIC FACTORS When attempting to explain or predict the extent of adult partic-ipation in continuous learning, researchers in adult education and the nursing profession typically resort to an analysis of various personal, social and economic characteristics ( 9, 31 ). In Johnstone and Rivera's study, only three factors emerged that persistently distinquished partic-pants from non-participants ( 26 ). The least significant feature of participants was their geographical location. Residents of urban centers participated in adult education a c t i v i t i e s to a greater degree than did adults from small c i t i e s , towns, and rural areas. Differences in the rate of participation were also, attributed to age. The majority of participants (57%) were under the age of forty and over three-quarters (79%) were under f i f t y . The over representation of younger adults i n continuous learning a c t i v i t i e s was also reflected in the fact that the median age of participants 20 w a s 3 6 . 5 o r s i x y e a r s y o u n g e r t h a n t h e a v e r a g e a g e o f t h e s a m p l e . T h e m o s t o u t s t a n d i n g c h a r a c t e r i s t i c o f p a r t i c i p a n t s i s t h a t t h e y a r e b e t t e r e d u c a t e d t h a n t h e a v e r a g e a d u l t . W h i l e t h e n u m b e r o f y e a r s o f s c h o o l i n g w a s a s s o c i a t e d w i t h o t h e r s o c i a l f a c t o r s s u c h a s o c c u p a t i o n a n d i n c o m e , f o r m a l e d u c a t i o n w a s r e p o r t e d t o b e t h e m o s t p o w e r f u l d e t e r m i n a n t o f p a r t i c i p a t i o n b y f a r . T h e s t u d i e s d i s c u s s e d i n N a k a m o t o a n d V e r n e r ' s r e v i e w o f t h e n u r s i n g l i t e r a t u r e g e n e r a l l y r e p o r t f i n d i n g s s i m i l a r t o t h o s e d e s c r i b e d i n t h e b r o a d e r f i e l d o f a d u l t e d u c a t i o n . C e r t a i n l y n u r s e s a t t e n d i n g v a r i o u s c o n t i n u i n g n u r s i n g e d u c a t i o n c o u r s e s a n d c o n f e r e n c e s t e n d t o c o m e e x c l u s i v e l y f r o m t h e s t a t e o r p r o v i n c e i n w h i c h t h e y a r e o f f e r e d . E v e n w i t h i n t h a t g e o g r a p h i c a l l i m i t a t i o n , p a r t i c i p a n t s e s s e n t i a l l y r e p r e s e n t t h e m o r e c e n t r a l u r b a n c o m -m u n i t i e s . T h i s p a t t e r n h a s b e e n a t t r i b u t e d t o t h e p r e d o m i n a n t l y c e n t r a l i z e d a n d u r b a n l o c a t i o n o f m o s t c o n t i n u i n g n u r s i n g e d u c a t i o n e v e n t s a n d t h e c o n -s e q u e n t p r o h i b i t i v e e x p e n s e f o r n u r s e s a t t e n d i n g f r o m o t h e r r e g i o n s . E v e n t h o u g h t h i s f a c t o r , i s n o t o f c o n c e r n i n t h e p r e s e n t s t u d y , i t h a s p o s e d a p r o b l e m f o r t h e p r o f e s s i o n a s i t a t t e m p t s t o e n s u r e e q u i t a b l e a c c e s s t o c o n t i n u o u s l e a r n i n g f o r a l l i t s m e m b e r s . T h e r e l a t i o n s h i p b e t w e e n e d u c a t i o n a l a c h i e v e m e n t a n d p a r t i c i p a t i o n i n c o n t i n u i n g n u r s i n g e d u c a t i o n c a n n o t b e a c c o u n t e d f o r q u i t e s o s i m p l y a n d s u c c i n c t l y . W h i l e N a k a m o t o a n d V e r n e r r e f e r t o t w o s t u d i e s i n w h i c h t h e d a t a a r e c o n s i s t e n t w i t h t h e f i n d i n g s i n a d u l t e d u c a t i o n , t h e y a l s o r e p o r t o n t w o o t h e r s t h a t f o u n d e d u c a t i o n a l b a c k g r o u n d d i d n o t c o r r e l a t e w i t h i n v o l v e m e n t i n c o n t i n u i n g e d u c a t i o n p r o g r a m s . M o r e r e c e n t l y , S o v i e d e t e r m i n e d t h a t n u r s i n g p r e p a r a t i o n r e l a t e d n e g a t i v e l y t o h e r s a m p l e ' s e n g a g e m e n t i n t o t a l e d u c a t i o n a l a c t i v i t i e s . S h e a t t r i b u t e d t h e s u r p r i s i n g f a c t t h a t d e g r e e n u r s e s p a r t i c i p a t e d t o a l e s s e r e x t e n t t o t h e s m a l l , n o n - r e p r e s e n t a t i v e n u m b e r o f u n i v e r s i t y g r a d -u a t e s i n t h e s a m p l e . I t i s i m p o r t a n t t o n o t e t h a t w h i l e S o v i e c o l l e c t e d e d u c a t i o n a l b a c k g r o u n d d a t a a c c o r d i n g t o t h e c a t e g o r i e s o f a s s o c i a t e d e g r e e , d i p l o m a a n d b a c c a l a u r e a t e d e g r e e p r o g r a m s , s h e c o n s i d e r e d t h e c l a s s i f i c a t i o n s o f n u r s i n g p r e p a r a t i o n i n l i n e a r f a s h i o n . O r g a n i z i n g t h e d a t a a c c o r d i n g t o t h e r e l a t i v e l e n g t h o f t h e p r o g r a m s ( t w o y e a r a s s o c i a t e d e g r e e , t h r e e y e a r d i p l o m a , a n d f o u r y e a r b a c c a l a u r e a t e d e g r e e ) d i s r e g a r d s s i g n i f i c a n t p h i l o s o p h i c a l a n d c u r r i c u l a r d i f f e r e n c e s a m o n g t h e p r o g r a m s . B o t h t h e a s s o c i a t e d e g r e e a n d b a c c a l a u r e a t e d e g r e e p r o g r a m s a r e s i t u a t e d i n e d u c a t i o n a l r a t h e r t h a n s e r v i c e - o r i e n t e d h e a l t h c a r e i n s i t u t i o n s a n d t h e r e f o r e a r e t h o u g h t t o r e f l e c t a m o r e l i b e r a l e d u c a t i o n a l f o c u s . I n a s -m u c h a s a s s o c i a t e d e g r e e p r o g r a m s l i k e t h e i r C a n a d i a n c o m m u n i t y c o l l e g e c o u n t e r p a r t s a r e e s s e n t i a l l y c o m m i t t e d t o o f f e r i n g a t e c h n i c a l o r v o c a t i o n a l t r a i n i n g , g r a d u a t e s o f t h e f o u r y e a r u n i v e r s i t y p r o g r a m s s h o u l d b e e v e n m o r e d i r e c t e d t o a l i f e - l o n g l e a r n i n g a p p r o a c h t o p r o f e s s i o n a l p r a c t i c e . I t w o u l d a p p e a r t h a t t h e c r i t i c a l e d u c a t i o n a l f a c t o r i s n o t t h e n u m b e r o f y e a r s o f f o r m a l e d u c a t i o n b u t r a t h e r t h e n a t u r e o f e d u c a t i o n a l p r e p a r a t i o n r e c e i v e d b y n u r s e s . I n C a n a d a , t h e t h r e e m o s t f a m i l i a r p r o g r a m s a r e t h e t h r e e y e a r h o s p i t a l d i p l o m a p r o g r a m , t h e t w o y e a r c o m m u n i t y c o l l e g e p r o g r a m a n d t h e f o u r y e a r u n i v e r s i t y d e g r e e p r o g r a m . W i t h t h e e m p h a s i s o n t h e i m p o r t a n c e o f a d v a n c e d p r e p a r a t i o n f o r n u r s e s a s p i r i n g t o p o s i t i o n s o f c l i n i c a l a n d f u n c t i o n a l e x p e r t i s e s u c h a s c l i n i c a l s p e c i a l i s t s , t e a c h i n g a n d a d m i n i s t r a t i o n , t h e r e i s a n i n c r e a s i n g t r e n d f o r d i p l o m a g r a d u a t e s t o t a k e a p o s t - g r a d u a t e u n i v e r s i t y d e g r e e i n n u r s i n g . T h e r e i s a l s o a g r e a t e r n u m b e r o f n u r s e s p r o c e e d i n g t o a m a s t e r s d e g r e e i n n u r s i n g a n d o t h e r r e l a t e d f i e l d s . A s F l a h e r t y f o u n d , n u r s e s w i t h u n i v e r s i t y p r e p a r a t i o n p a r t i c i p a t e d m o r e i n c o n t i n u o u s l e a r n i n g a c t i v i t i e s t h a n d i d d i p l o m a g r a d u a t e s ( 2 1 ) . T h i s w o u l d s u g g e s t t h a t i t m i g h t b e m o r e p e r t i n e n t t o e x a m i n e t h e i n f l u e n c e o f t h e d i f f e r e n t t y p e s o f n u r s i n g e d u c a t i o n o n p a r t i c i p a t i o n r a t e s r a t h e r t h a n t h e a c t u a l n u m b e r o f y e a r s o f f o r m a l e d u c a t i o n a s n u r s e s a r e r e l a t i v e l y h o m o g e n e o u s w i t h r e s p e c t t o t h e n u m b e r o f y e a r s o f e d u c a t i o n r e c e i v e d c o m -p a r e d t o t h e g e n e r a l a d u l t p o p u l a t i o n , a l t h o u g h t h e r e i s s o m e d i f f e r e n c e a m o n g n u r s e s w i t h r e s p e c t t o t h e m i l i e u i n w h i c h t h e e d u c a t i o n i s o b t a i n e d . A g e h a s n o t e m e r g e d a s a c l e a r p r e d i c t o r o f p a r t i c i p a t i o n i n c o n -t i n u i n g n u r s i n g e d u c a t i o n . S o v i e d i d n o t r e p o r t a n y s i g n i f i c a n t r e l a t i o n -s h i p b e t w e e n a g e a n d p a r t i c i p a t i o n , w h i l e t h e S e c o n d A n n u a l R e p o r t o f C o n t i n u i n g E d u c a t i o n i n N u r s i n g a t t h e U n i v e r s i t y o f B r i t i s h C o l u m b i a d e s c r i b e d a g e n e r a l l y e q u a l d i s t r i b u t i o n o f p a r t i c i p a n t s i n a l l a g e g r o u p s e x c e p t f o r a m a r k e d d e c r e a s e i n t h o s e o v e r 5 5 y e a r s o f a g e ( 3 5 ) . I n c o n t r a s t , C o o p e r a n d H o r n b a c k f o u n d t h a t t h e l a r g e s t p e r c e n t a g e o f p a r t i c -p a n t s w e r e i n t h e 5 0 - 5 4 y e a r s a g e g r o u p ( 1 4 ) • W h i l e t h i s r a t h e r c o n t r a -d i c t o r y d a t a w o u l d s u g g e s t t o s o m e t h a t f u r t h e r s t u d y i s r e q u i r e d , i t a l s o r a i s e s t h e q u e s t i o n a s t o w h e t h e r a g e i s i n f a c t a n i r r e l e v a n t p a r t i c i p a n t c h a r a c t e r i s t i c a n d s h o u l d n o t b e i n c l u d e d i n f u t u r e r e s e a r c h c o n s i d e r a t i o n s . O t h e r p e r s o n a l a n d s o c i o - e c o n o m i c f a c t o r s h a v e b e e n f r e q u e n t l y i d e n t i f i e d i n t h e n u r s i n g l i t e r a t u r e a s r e l a t e d t o p a r t i c i p a t i o n . A f e w f a c t o r s i n c l u d i n g m a r i t a l s t a t u s , n u m b e r o f c h i l d r e n , a n d e m p l o y m e n t s t a t u s h a v e b e e n s y s t e m a t i c a l l y s t u d i e d ( 2 1 , 3 7 , 3 1 ) . G e n e r a l l y , s i n g l e n u r s e s t e n d t o p a r t i c i p a t e m o r e a c t i v e l y t h a n t h e i r m a r r i e d c o l l e a g u e s . F o r t h o s e p a r t i c i p a n t s w h o a r e m a r r i e d t h e r e a p p e a r s t o b e a n e g a t i v e c o r r e l a t i o n b e t w e e n t h e t o t a l n u m b e r o f c h i l d r e n a n d i n v o l v e m e n t i n c o n t i n u o u s l e a r n i n g . T h e c o m p e t i n g d e m a n d s o f d o m e s t i c r e s p o n s i b i l i t i e s h a v e o f t e n b e e n c i t e d a s d e t e r r e n t s t o p a r t i c i p a t i o n . T h e f i n d i n g s w i t h r e s p e c t t o e m p l o y m e n t s t a t u s a r e q u i t e c o n s i s t e n t . N u r s e s w h o a r e f u l l - t i m e e m p l o y e e s o f h e a l t h c a r e a g e n c i e s p a r t i c i p a t e m o r e t h a n d o p a r t - t i m e s t a f f . I n p a r t i c u l a r , s u p e r v i s o r y p e r s o n n e l p r e d i c t a b l y m a k e u p t h e l a r g e s t s i n g l e g r o u p o f n u r s e p a r t i c i p a n t s . S e v e r a l e x p l a n a t i o n s ( 1 4 ) h a v e b e e n p u t f o r x j a r d , b u t a s y e t n o d e f i n i t i v e r e a s o n f o r t h i s o c c u r r e n c e h a s b e e n e s t a b l i s h e d . S U M M A R Y W h i l e t h e r e s e a r c h d o n e i n a d u l t e d u c a t i o n s u g g e s t s t h a t a d u l t s a c t i v e l y e n g a g e i n v a r i o u s f o r m s o f l e a r n i n g e x p e r i e n c e s , t h e r e i s l i t t l e e v i d e n c e a s y e t w i t h r e s p e c t t o t h e r a t e o f p a r t i c i p a t i o n o f n u r s e s i n c o n t i n u i n g t h e i r e d u c a t i o n . T h o s e s t u d i e s w h i c h h a v e e x p l o r e d t h e c h a r a c -t e r i s t i c s o f n u r s e s w h o p a r t i c i p a t e i n c o n t i n u o u s l e a r n i n g a n d t h e e x t e n t t o w h i c h t h e y d o s o , t e n d t o f o c u s o n t h e m o r e f o r m a l , g r o u p - o r i e n t e d a n d n o n - c r e d i t c o m p o n e n t s o f c o n t i n u i n g n u r s i n g e d u c a t i o n . H e n c e , t h e r e i s a n e e d t o i n v e s t i g a t e n u r s e s ' i n v o l v e m e n t i n b o t h i n d e p e n d e n t a n d d e p e n d e n t t y p e s o f c o n t i n u o u s l e a r n i n g a c t i v i t i e s , a n d t o a s c e r t a i n t h o s e p s y c h o l o g i c a l a n d s o c i o - e c o n o m i c f a c t o r s w h i c h s e r v e t o e x p l a i n a n d p r e d i c t t h e e x t e n t o f t h a t i n v o l v e m e n t . A d u l t e d u c a t o r s h a v e d i r e c t e d c o n s i d e r a b l e a t t e n t i o n t o t h e m o t i v a -t i o n a l a n d a t t i t u d i n a l c h a r a c t e r i s t i c s o f t h e i r c l i e n t e l e , w h e r e a s t h e a n u r s i n g p r o f e s s i o n h a s f o r t h e m o s t p a r t f o c u s e d p r i m a r i l y o n t h e s o c i o -e c o n o m i c f a c t o r s . S i n c e a d u l t l e a r n e r s ' r e a s o n s f o r e n g a g i n g i n e d u c a t i o n a l 2 4 e v e n t s a n d t h e i r a t t i t u d e s t o c o n t i n u i n g t h e i r l e a r n i n g h a v e b e e n s h o w n t o i n f l u e n c e t h e i r l e v e l s o f p a r t i c i p a t i o n , i t i s i m p o r t a n t t h a t t h e s e s a m e v a r i a b l e s b e e x p l o r e d w i t h t h e m o r e s p e c i f i c a d u l t p o p u l a t i o n o f n u r s e s . I n a d d i t i o n , i t h a s b e e n d e m o n s t r a t e d t h a t c e r t a i n s o c i o - e c o n o m i c c h a r a c t e r i s t i c s s u c h a s g e o g r a p h i c a l l o c a t i o n , a g e a n d e d u c a t i o n a l p r e p a r -a t i o n a f f e c t a d u l t s ' i n v o l v e m e n t i n l e a r n i n g a c t i v i t i e s . A s y e t , n u r s i n g r e s e a r c h h a s n o t c l a r i f i e d t h e r e l a t i o n s h i p o f t h e s e a n d o t h e r s o c i o - e c o n o m i c f a c t o r s t o p a r t i c i p a t i o n i n c o n t i n u i n g n u r s i n g e d u c a t i o n . T h i s n e e d s t o b e d o n e i n o r d e r t h a t t h o s e r e s p o n s i b l e f o r p l a n n i n g a n d i m p l e m e n t i n g d i f f e r e n t k i n d s o f c o n t i n u o u s l e a r n i n g e x p e r i e n c e s f o r n u r s e s c a n d o s o i n a k n o w l e d g -a b l e a n d r a t i o n a l m a n n e r . C H A P T E R I I I METHODOLOGY T h i s s t u d y w a s a n a n a l y t i c a l s u r v e y o f n u r s e s ' p a r t i c i p a t i o n i n c o n t i n u o u s l e a r n i n g a c t i v i t i e s o f t w o s p e c i f i c t y p e s c l a s s i f i e d a s d e p e n -d e n t a n d i n d e p e n d e n t . I t a l s o i n v e s t i g a t e d n u r s e s ' r e a s o n s f o r e n g a g i n g i n c o n t i n u o u s l e a r n i n g a n d t h e i r a t t i t u d e s t o w a r d c o n t i n u i n g n u r s i n g e d u c a t i o n . T h e s t u d y t h e n e x a m i n e d t h e r e l a t i o n s h i p o f t h e e x t e n t o f p a r t i c i p a t i o n i n i n d e p e n d e n t , d e p e n d e n t a n d t o t a l n u r s i n g l e a r n i n g a c t i v -i t i e s t o t h e t w o p s y c h o l o g i c a l c h a r a c t e r i s t i c s a n d c e r t a i n s o c i o - e c o n o m i c f a c t o r s . P O P U L A T I O N T h e p o p u l a t i o n o f n u r s e s d e f i n e d f o r t h e p u r p o s e s o f t h i s s t u d y i n c l u d e d t h o s e f e m a l e r e g i s t e r e d n u r s e s w h o w e r e e m p l o y e d o n a f u l l - t i m e o r p a r t - t i m e b a s i s b y g e n e r a l h o s p i t a l s i n t h e G r e a t e r V a n c o u v e r a r e a . T h e s e l e c t i o n o f h o s p i t a l s w a s r e s t r i c t e d t o t h o s e o f m e d i u m s i z e ( 3 0 0 t o 7 0 0 b e d s ) w h i c h h a d a d i r e c t o r o r c o o r d i n a t o r o f i n s e r v i c e e d u c a t i o n . T h e h o s p i t a l s c h o s e n o n t h e b a s i s o f t h e s e c r i t e r i a i n c l u d e d : B u r n a b y G e n e r a l H o s p i t a l , L i o n ' s G a t e H o s p i t a l , R o y a l C o l u m b i a n H o s p i t a l , S t . P a u l ' s H o s p i t a l , a n d S u r r e y M e m o r i a l H o s p i t a l . 2 5 2 6 T h e s u r v e y w a s l i m i t e d t o t h e f e m a l e m e m b e r s o f t h e p r o f e s s i o n s i n c e n u r s i n g i s s t i l l a p r e d o m i n a n t l y f e m a l e c a r e e r c h o i c e . A c c o r d i n g t o t h e m o s t c u r r e n t a v a i l a b l e s t a t i s t i c s , o n l y 1 2 1 o f t h e 1 1 , 7 8 1 n u r s e s r e g i s t e r e d i n t h e p r o v i n c e o f B r i t i s h C o l u m b i a i n 1 9 7 2 w e r e m a l e ( 3 4 ) . W h i l e m o s t o f t h e m ( 1 0 0 ) w e r e e m p l o y e d i n h o s p i t a l s , t h e y a c c o u n t e d f o r m e r e l y 1 . 0 p e r c e n t o f t h e t o t a l p o p u l a t i o n o f r e g i s t e r e d n u r s e s e m p l o y e d i n h o s p i t a l s o r o t h e r i n s t i t u t i o n s . T h e i r i n c l u s i o n i n t h e s t u d y w o u l d s e v e r e l y r e s t r i c t t h e a p p l i c a t i o n o f c e r t a i n s t a t i s t i c a l p r o c e d u r e s a n d t h e i n t e r p r e t a t i o n o f r e s u l t s , s o t h a t f e m a l e s o n l y w e r e i n c l u d e d . I n a s m u c h a s c o n t i n u o u s l e a r n i n g i s p r o c l a i m e d t o b e o n e o f t h e c r i t i c a l d i s c r i m i n a n t s b e t w e e n p r o f e s s i o n a l s a n d n o n - p r o f e s s i o n a l s , i t w a s d e c i d e d t h a t t h e s t u d y w o u l d s u r v e y o n l y t h o s e n u r s e s w h o b e l o n g t o t h e p r o f e s s i o n a l a s s o c i a t i o n . T h e s e n u r s e s h a v e g r a d u a t e d f r o m r e c o g n i z e d s c h o o l s o f n u r s i n g , w e r e a c t i v e m e m b e r s o f t h e R e g i s t e r e d N u r s e s ' A s s o c i -a t i o n o f B r i t i s h C o l u m b i a ( R . N . A . B . C . ) a n d w e r e c e r t i f i e d a s r e g i s t e r e d m e m b e r s o f t h e A s s o c i a t i o n w h i c h e n t i t l e s t h e m t o t h e s t a t u s o f ' R e g i s t e r e d N u r s e ' . I t w a s i n t e n d e d t h a t t h i s i n v e s t i g a t i o n w o u l d d e t e r m i n e , i n s o m e m e a s u r e a t l e a s t , w h e t h e r o r n o t n u r s e s w h o a r e r e g a r d e d t o b e p r o f e s s i o n a l i n f a c t a s s u m e t h e r e s p o n s i b i l i t y o f a p r o f e s s i o n a l p r a c t i t i o n e r ; t h a t i s m a i n t a i n t h e i r c o m p e t e n c y t o p r a c t i c e b y f u r t h e r i n g t h e i r e d u c a t i o n . T h e r e m a i n i n g l i m i t s o n t h e p o p u l a t i o n w e r e s e t i n o r d e r t o p e r m i t a s w i d e a d i s t r i b u t i o n o f r a t e s o f p a r t i c i p a t i o n a s p o s s i b l e . I n a d d i t i o n , t h e s e c r i t e r i a s u f f i c i e n t l y p a r a l l e l t h o s e u s e d i n o t h e r s t u d i e s t o f a c i l -i t a t e a m e a n i n g f u l c o m p a r i s o n o f r e s u l t s . T h o s e n u r s e s w o r k i n g i n h o s p i t a l s o n a c a s u a l o r r e l i e f b a s i s w e r e e l i m i n a t e d o n t h e b a s i s o f t h e i r l i m i t e d a c c e s s t o c e r t a i n . l e a r n i n g a c t i v i t i e s . G e n e r a l r a t h e r t h a n s p e c i a l t y h o s p i t a l s w e r e s e l e c t e d i n o r d e r t o r e f l e c t t h e p a r t i c i p a t i o n o f - n u r s e s i n a s w i d e a v a r i e t y o f a c t i v i t i e s a s p o s s i b l e . N u r s e s e m p l o y e d i n s p e c i a l t y a g e n c i e s w o u l d b e e x p e c t e d t o l i m i t t h e r a n g e o f t h e i r p a r t i c i p a t i o n a c c o r d i n g t o t h e i r u n i q u e l e a r n i n g n e e d s . O n l y t h o s e g e n e r a l h o s p i t a l s i n t h e G r e a t e r V a n c o u v e r a r e a w i t h a 3 0 0 t o 7 0 0 b e d c a p a c i t y a n d a d i r e c t o r o r c o o r d i n a t o r o f i n s e r v i c e e d u c a t i o n w e r e s e l e c t e d a s a m e a n s o f e n s u r i n g g e n e r a l a v a i l a b i l i t y o f a l l t h e c o n t i n u o u s l e a r n i n g a c t i v i t i e s u n d e r c o n s i d e r a t i o n . T h e l a c k o f a v a i l a b l e l e a r n i n g o p p o r t u n i t i e s h a s f r e q u e n t l y b e e n i d e n t i f i e d a s a r e a s o n w h y n u r s e s d o n o t a c t i v e l y p a r t i c i p a t e ( 3 1 , 5 ) . H o s p i t a l s o f t h e s i z e s p e c i f i e d f o r t h i s i n v e s t i g a t i o n w h i c h h a v e o n s t a f f , p e r s o n n e l r e s p o n s i b l e f o r p l a n n i n g a n d c o o r d i n a t i n g i n s e r v i c e e d u c a t i o n c o u l d r e a s o n a b l y b e e x p e c t e d t o p r o v i d e c e r t a i n e d u c a t i o n a l p r o g r a m s a n d r e s o u r c e s s u c h a s o r i e n t a t i o n a n d s t a f f d e v e l o p m e n t p r o g r a m s , a n d r e a d i n g m a t e r i a l s . I n s u m m a r y i t w a s a s s u m e d t h a t n u r s e s e m p l o y e d i n t h e s e f i v e h o s p i t a l s w o u l d h a v e a v a i l a b l e t o t h e m a f u l l r a n g e o f c o n t i n u i n g l e a r n i n g a c t i v i t i e s . W h e t h e r o r n o t t h e s e s a m e n u r s e s w e r e a w a r e t h a t t h e s e a c t i v -i t i e s e x i s t e d o r h a d e a s y a c c e s s t o t h e m a r e t w o e q u a l l y i m p o r t a n t q u e s t i o n s t h a t c o u l d n o t b e a n s w e r e d b y t h i s p a r t i c u l a r s t u d y . I n o r d e r t o a s c e r t a i n t h e a c t u a l s i z e o f t h e d e f i n e d p o p u l a t i o n l e t t e r s o f e n q u i r y w e r e s e n t t o t h e d i r e c t o r s o f n u r s i n g o f t h e f i v e h o s -p i t a l s ( A p p e n d i x A ) . T h e t o t a l n u m b e r o f r e g i s t e r e d n u r s e s e m p l o y e d b y t h e h o s p i t a l s o n a f u l l o r p a r t - t i m e b a s i s w a s e s t a b l i s h e d t o b e 1 2 4 0 . T a b l e 1 s h o w s t h e d i s t r i b u t i o n o f t h e n u m b e r a n d p e r c e n t a g e o f r e g i s t e r e d n u r s e s e m p l o y e d i n t h e h o s p i t a l s w h i c h h a d g i v e n p e r m i s s i o n f o r t h e s t u d y t o b e c o n d u c t e d i n t h e i r i n s t i t u t i o n . 28 Table 1 Number and Percentage D i s t r i b u t i o n of Regis tered Nurses Employed i n the F i v e Hosp i ta l s Number Number of Percentage of H o s p i t a l of Beds a Regis tered Nurses T o t a l P o p u l a t i o n 0 Burnaby General H o s p i t a l 384 150 12.1 L i o n ' s Gate H o s p i t a l 647 280 22.6 Royal Columbian H o s p i t a l 425 300 24.2 S t . P a u l ' s H o s p i t a l 573 320 25.8 Surrey Memorial H o s p i t a l 369 190 15.3 T o t a l P o p u l a t i o n : 1240 T o t a l : 100.0% a . S t a t i s t i c s from the Canadian H o s p i t a l D i r e c t o r y , 1972 (11). b . Est imates of the number of r e g i s t e r e d nurses employed i n each h o s p i t a l as provided by the d i r e c t o r s of n u r s i n g . c . Percentages used i n the c a l c u l a t i o n of the sample drawn p r o p o r t i o n a t e l y from each h o s p i t a l . SAMPLE A sample s i z e of 250 was predetermined as being adequate to f u l f i l l the necessary requirements for a study of t h i s na ture . A p r o p o r t i o n a l s t r a t i f i e d sampling procedure was used to ensure that each h o s p i t a l was a p p r o p r i a t e l y represented i n the sample ( 38 ) . A l i s t of random numbers was obtained using one of the U n i v e r s i t y of B r i t i s h Columbia Computing Center ' s random number generators . The product ion of n i n e t y - t h r e e extra d i g i t s 29 f a c i l i t a t e d the drawing of a l t e r n a t e names to o f f s e t probable sample mor-t a l i t y and thereby created a t o t a l of 343 p o t e n t i a l respondents. L e t t e r s were sent (Appendix B ) to the r e g i s t e r e d nurses randomly se lec ted from the h o s p i t a l s ' nurs ing s t a f f f i l e s asking them to p a r t i c i p a t e i n the study by completing a quest ionnaire that would be administered i n prearranged group ses s ions . DEVELOPMENT OF THE INSTRUMENT I t was decided that the data requ ired for the purposes of t h i s study could most e f f e c t i v e l y and e f f i c i e n t l y be c o l l e c t e d by means of a q u e s t i o n -n a i r e . The instrument was developed i n four p a r t s ; a) p a r t i c i p a t i o n index, b) a t t i t u d e s c a l e , c) Learning O r i e n t a t i o n Index, d) b i o g r a p h i c a l in format ion (Appendix C ). P a r t i c i p a t i o n Index An index of 22 se lec ted a c t i v i t i e s was created to measure nurses ' p a r t i c i p a t i o n i n p r o f e s s i o n a l l y - o r i e n t e d continuous l e a r n i n g . Eleven items r e l a t e d to independent type l e a r n i n g a c t i v i t i e s while eleven represented dependent a c t i v i t i e s . Thus the index provided two sub-scores one for each type of l e a r n i n g a c t i v i t y , i n a d d i t i o n to a t o t a l s core . In developing t h i s index, a comprehensive l i s t of cont inu ing l e a r n i n g a c t i v i t i e s a v a i l a b l e to nurses i n the Greater Vancouver area was compiled i n c o n s u l t a t i o n with two f a c u l t y members from the D i v i s i o n of Cont inuing Nursing Educat ion , School of Nurs ing , U n i v e r s i t y of B r i t i s h Columbia. These a c t i v i t i e s w e r e r e p r e s e n t a t i v e o f t h e v a r i o u s a g e n c i e s , i n s t i t u t i o n s a n d a s s o c i a t i o n s t h a t s p o n s o r c o n t i n u i n g n u r s i n g e d u c a t i o n . T h e y a l s o r e f l e c t e d t h o s e a s p e c t s o f l e a r n i n g f o r w h i c h t h e i n d i v i d u a l n u r s e , h e a l t h c a r e a g e n c i e s , e d u c a t i o n a l i n s t i t u t i o n s a n d t h e p r o f e s s i o n a l a s s o c i a t i o n a s s u m e r e s p o n -s i b i l i t y . I n o r d e r t o v a l i d a t e t h e d i f f e r e n t i a t i o n b e t w e e n i n d e p e n d e n t a n d d e p e n d e n t t y p e s o f l e a r n i n g , t h e l i s t w a s t h e n s u b j e c t e d t o a j u d g i n g p r o -c e d u r e . F i f t e e n c o n t i n u i n g n u r s i n g e d u c a t o r s w e r e a s k e d t o c l a s s i f y t h e a c t i v i t i e s i n t o t h e t w o t y p e s - i n d e p e n d e n t a n d d e p e n d e n t a c c o r d i n g t o t h e d e f i n i t i o n s u s e d i n t h i s s t u d y . W h i l e t h e j u d g e s e s s e n t i a l l y a g r e e d t h a t a l l t h e i t e m s c o n s t i t u t e d l e a r n i n g a c t i v i t i e s f o r n u r s e s s o m e i t e m s w e r e d i s c a r d e d o n t h e b a s i s o f a d i v e r g e n c e o f o p i n i o n a s t o t h e i r c l a s s i f i c a t i o n . T h e r e f o r e , o n l y t h o s e i t e m s t h a t w e r e j u d g e d t o b e e i t h e r i n d e p e n d e n t o r d e p e n d e n t b y t e n o r m o r e o f t h e c o n t i n u i n g n u r s i n g e d u c a t o r s w e r e i n c l u d e d i n t h e p a r t i c i p a t i o n i n d e x . T h e 2 2 a c t i v i t i e s w e r e s u b s e q u e n t l y d i s t r i b u t e d r a n d o m l y t h r o u g h t h e i n d e x s o a s t o r e d u c e t h e e x t e n t o f b i a s e d r e s p o n s e . N o a t t e m p t w a s m a d e t o q u a n t i f y t h e a m o u n t o f p a r t i c i p a t i o n i n e a c h a c t i v i t y o r t h e ' e d u c a b i l i t y ' o f e a c h a c t i v i t y ( 3 7 ) . T h e i n d e x m e r e l y m e a s u r e d w h e t h e r o r n o t n u r s e s h a d p a r t i c i p a t e d i n t h e p a r t i c u l a r l e a r n i n g a c t i v i t i e s o v e r t h e t w e l v e m o n t h p e r i o d e n d i n g S e p t e m b e r 3 0 , 1 9 7 3 . T h e r e s p o n s e s w e r e t h e n s c o r e d a c c o r d i n g t o t h e f o l l o w i n g s c h e m e : ' D i d P a r t i c -i p a t e ' = o n e , ' D i d N o t P a r t i c i p a t e ' = z e r o . T h e c a l c u l a t e d s u b - s c o r e s a n d t o t a l s c o r e s t h e r e f o r e c o n s t i t u t e o r d i n a l d a t a b u t f o r t h e p u r p o s e s o f s t a t i s t i c a n a l y s e s w e r e t r e a t e d a s i n t e r v a l d a t a . T h i s v i o l a t i o n o f t h e a s s u m p t i o n u n d e r l y i n g t h e u s e o f p a r a m e t r i c s t a t i s t i c a l p r o c e d u r e s t h a t " m e a s u r e s t o b e a n a l y z e d a r e c o n t i n u o u s m e a s u r e s w i t h e q u a l i n t e r v a l s " ( 2 7 ) 3 1 w a s b a s e d o n t h e a r g u m e n t s p u t f o r t h b y B o n e a u a n d A n d e r s o n ( 8 , 2 ) . A t t i t u d e S c a l e S i n c e n o r e s e a r c h t o o l s t h a t d i r e c t l y m e a s u r e a t t i t u d e s t o c o n t i n -u i n g n u r s i n g e d u c a t i o n w e r e f o u n d i n t h e r e v i e w o f t h e l i t e r a t u r e , i t w a s d e c i d e d t o a d a p t t h e A d o l p h - W h a l e y s c a l e p r e v i o u s l y u s e d t o d e t e r m i n e a t t i t u d e s t o w a r d a d u l t e d u c a t i o n ( 1 ) . A d o l p h a n d W h a l e y ' s 2 4 s c a l e s t a t e m e n t s w e r e r e w r i t t e n s o a s t o b e p e r t i n e n t t o n u r s e s a n d c o n t i n u i n g n u r s i n g e d u c a t i o n . E v e r y e f f o r t w a s m a d e t o r e t a i n t h e o r i g i n a l m e a n i n g o f e a c h s t a t e m e n t . T h e s t a t e m e n t s w e r e t h e n s u b j e c t e d t o j u d g i n g a n d s e l -e c t i o n p r o c e d u r e s s i m i l a r t o t h o s e d e s c r i b e d b y A d o l p h a n d W h a l e y . T h e f i f t e e n c o n t i n u i n g n u r s i n g e d u c a t o r s w e r e a s k e d t o r a t e t h e f a v o u r a b i l i t y o f e a c h s t a t e m e n t . O n t h e b a s i s o f t h e i r r e s p o n s e s , t h e m e a n o f t h e r a t i n g s g i v e n t o e a c h s t a t e m e n t w a s c a l c u l a t e d , f o l l o w e d b y t h e f i r s t a n d t h i r d q u a r t i l e p o i n t s f o r e a c h i t e m . T h e Q - v a l u e ( i n t e r q u a r t i l e r a n g e ) w a s u s e d t o e l i m i n a t e a m b i g u o u s i t e m s . A s a r e s u l t , s i x i t e m s w i t h a Q -v a l u e o f t w o o r g r e a t e r w e r e d i s c a r d e d ( 2 8 ) . I n a d d i t i o n , t h e j u d g e s w e r e a s k e d t o i n d i c a t e w h e t h e r t h e y c o n s i d -e r e d a n y o f t h e 2 4 m o d i f i e d s t a t e m e n t s t o b e i r r e l e v a n t w i t h r e g a r d t o c o n -t i n u i n g n u r s i n g e d u c a t i o n . W h i l e a n u m b e r o f t h e s t a t e m e n t s w e r e n o t t h o u g h t t o b e p e r t i n e n t t o c o n t i n u i n g n u r s i n g e d u c a t i o n b y o n e o r t w o o f t h e j u d g e s , n o n e w e r e r e j e c t e d b y m o r e t h a n o n e - t h i r d . " G r a d u a t e n u r s e s c a n n o t m e m o r i z e a s e a s i l y a s y o u n g e r s t u d e n t n u r s e s " w a s t h e i t e m j u d g e d t o b e i r r e l e v a n t b y t h e g r e a t e s t n u m b e r ( 5 ) . A f e w o f t h e c o n t i n u i n g n u r s i n g e d u c a t o r s s p o n t a n e -o u s l y c o m m e n t e d t h a t a l l o f t h e i t e m s w e r e w o r t h i n c l u d i n g s i n c e e a c h o n e r e f l e c t e d a f r e q u e n t l y e x p r e s s e d a t t i t u d e t o w a r d c o n t i n u i n g n u r s i n g e d u c a t i o n . W h e n t h e s c a l e v a l u e s ( m e a n s ) o f t h e r e m a i n i n g e i g h t e e n i t e m s w e r e p l o t t e d a g a i n s t t h e s c a l e v a l u e r a n g e ( 1 - 9 ) i t w a s e v i d e n t t h a t t h e y n o l o n g e r o c c u r r e d a t e q u a l l y a p p e a r i n g i n t e r v a l s a s i n t h e o r i g i n a l a d u l t e d u c a t i o n s c a l e . I n s t e a d , t h e y t e n d e d t o p o l a r i z e t o w a r d t h e e x t r e m e e n d s o f t h e s c a l e . T h i s i s d i f f i c u l t t o e x p l a i n , b u t m a y h a v e o c c u r r e d b e c a u s e t h e s e p a r t i c u l a r e d u c a t o r s a p p e a r s t r o n g l y c o m m i t t e d t o c o n t i n u i n g n u r s i n g e d u c a t i o n a n d m a y h a v e t e n d e d t o p e r c e i v e t h e s t a t e m e n t s a s e i t h e r ' e x t r e m e -l y f a v o u r a b l e ' o r ' e x t r e m e l y u n f a v o u r a b l e ' . N o a t t e m p t w a s m a d e d u r i n g t h e j u d g i n g p r o c e d u r e t o a s c e r t a i n t h e r e a s o n s f o r t h e e d u c a t o r s ' j u d g e m e n t s . I n v i e w o f t h e f a c t t h a t t h e s t a t e m e n t s n o l o n g e r a p p r o x i m a t e d a T h u r s t o n e s c a l e , t h e i t e m s w e r e c o n v e r t e d t o a L i k e r t - t y p e i n s t r u m e n t b y p l a c i n g t h e r e s p o n s e s o n a f i v e p o i n t s c a l e r a n g i n g f r o m ' s t r o n g l y a g r e e ' t o ' s t r o n g l y d i s a g r e e ' . T h e s c o r e f o r e a c h i t e m w a s d e t e r m i n e d a c c o r d i n g t o w h e t h e r t h e i t e m h a d b e e n j u d g e d f a v o u r a b l e o r u n f a v o u r a b l e b y t h e c o n -t i n u i n g n u r s i n g e d u c a t o r s . F o r e x a m p l e , a f a v o u r a b l e s t a t e m e n t s u c h a s " F u r t h e r n u r s i n g e d u c a t i o n i n c r e a s e s o n e ' s s e l f - c o n f i d e n c e " w a s s c o r e d o n t h e b a s i s o f a r a n g e o f s c o r e s f r o m s t r o n g l y a g r e e ( 5 p o i n t s ) t o s t r o n g l y d i s a g r e e ( 1 p o i n t ) . A s t a t e m e n t j u d g e d t o b e u n f a v o u r a b l e , f o r e x a m p l e , " C o n t i n u i n g n u r s i n g e d u c a t i o n r e q u i r e s t o o m u c h t i m e a n d e f f o r t " , w a s t h e n s c o r e d i n t h e r e v e r s e m a n n e r , a c c o r d i n g t o a r a n g e o f s c o r e s f r o m s t r o n g l y a g r e e ( 1 p o i n t ) t o s t r o n g l y d i s a g r e e ( 5 p o i n t s ) . A t o t a l s c a l e s c o r e w a s c o m p u t e d f o r e a c h r e s p o n d e n t w i t h t h e r a n g e o f p o s s i b l e s c o r e s b e i n g 1 8 t o 9 0 . I n a d d i t i o n t o t h e e i g h t e e n i t e m a t t i t u d e s c a l e , t h e q u e s t i o n n a i r e i n c l u d e d a t e n i n t e r v a l s e l f - r a t i n g s c a l e s i m i l a r t o t h e o n e u s e d i n t h e A d o l p h - W h a l e y i n s t r u m e n t . A c o m p a r i s o n o f t h e s c o r e s o n t h e s e t w o s c a l e s 3 3 p e r m i t s a l i m i t e d t e s t o f c o n t e n t v a l i d i t y . L e a r n i n g O r i e n t a t i o n I n d e x S h e f f i e l d ' s L e a r n i n g O r i e n t a t i o n I n d e x w a s u s e d i n i t s e n t i r e t y t o m e a s u r e n u r s e s ' r e a s o n s f o r p a r t i c i p a t i n g i n a l l e d u c a t i o n a l a c t i v i t i e s o v e r t h e p a s t y e a r . T h e o r d e r o f a f e w o f t h e i t e m s a t t h e b e g i n n i n g o f t h e i n d e x w a s a l t e r e d s o a s t o r e i n f o r c e t h e r e s p o n d e n t s ' s e t t o c o m p l e t i n g t h e i n d e x o n t h e b a s i s o f t h e i r t o t a l e d u c a t i o n a l a c t i v i t i e s a n d n o t j u s t t h e i r i n v o l v e m e n t i n c o n t i n u i n g n u r s i n g e d u c a t i o n p r o g r a m s . T h e 5 8 i t e m i n d e x d i r e c t s r e s p o n s e s t o e a c h r e a s o n a c c o r d i n g t o a f i v e p o i n t s c a l e r a n g i n g f r o m ' V e r y f r e q u e n t l y i m p o r t a n t f o r m e ' ( 5 p o i n t s ) t o ' N e v e r i m p o r t -a n t f o r m e ' ( 1 p o i n t ) . T h e i n d i v i d u a l i t e m s s c o r e s s e r v e a s a b a s i s f o r d e t e r m i n i n g n u r s e s ' o r i e n t a t i o n s t o c o n t i n u o u s l e a r n i n g . B i o g r a p h i c a l I n f o r m a t i o n P a r t D o f t h e q u e s t i o n n a i r e w a s d e s i g n e d t o c o l l e c t c e r t a i n d a t a a b o u t t h e r e s p o n d e n t s i n o r d e r t o d e s c r i b e t h e s a m p l e a n d t o p e r m i t t e s t i n g t h e r e l a t i o n s h i p b e t w e e n s e l e c t e d s o c i o - e c o n o m i c c h a r a c t e r i s t i c s a n d t h e e x t e n t a n d n a t u r e o f p a r t i c i p a t i o n . T h o s e f a c t o r s i d e n t i f i e d i n t h e r e v i e w o f t h e l i t e r a t u r e a s b e i n g p a r t i c u l a r l y r e l e v a n t t o n u r s e s ' p a r t i c i p a t i o n i n c o n t i n u o u s l e a r n i n g w e r e i n c l u d e d . T h e s e w e r e a g e , m a r i t a l s t a t u s , n u m b e r o f c h i l d r e n , e d u c a t i o n a l b a c k g r o u n d , y e a r s s i n c e g r a d u a t i o n , y e a r s o f a c t i v e a n d i n a c t i v e p r a c t i c e , l e n g t h o f c u r r e n t e m p l o y m e n t , e m p l o y m e n t s t a t u s , a n d p o s i t i o n . A n t i c i p a t i n g t h a t t h e a g e o f n u r s e s ' c h i l d r e n w o u l d i n f l u e n c e t h e i r involvement in continuing nursing education more than merely the total number, respondents were asked to indicate specifically the number of children in pre-school, elementary and secondary school. With respect to their educational background, the nurses were directed to specify which type of basic nursing program they had taken (hospital diploma pro-gram, diploma program at a post-secondary educational institution, bacca-laurate degree program). Those having graduated from a program different from these three typical Canadian nursing programs were asked to specify the nature of their 'other' educational preparation. An additional question was included in order to differentiate between those nurses who had at some time had university education and those who did not. Two questions were posed to establish the full-time and part-time employment status of the respondents. Two additional items collected data pertinent to the nature of the nurses' position. Those items, (#14 and #16) structured to e l i c i t interval rather than nominal data, were included to describe more completely the characteristics of the sample. The respondents were asked to record their i n i t i a l nursing grad-uation date in order to establish the number of years since graduation. They were also asked to provide the number of years that they had actively practiced as a registered nurse and the length of time they had been employ-ed in their current hospital. Finally, the questionnaire included an item pertinent to nurses'clinical specialty. 35 P R E T E S T O F T H E I N S T R U M E N T T h e q u e s t i o n n a i r e w a s p r e t e s t e d i n t w o p h a s e s . I n i t i a l l y i t w a s c r i t i q u e d b y a p a n e l o f e l e v e n j u d g e s , t h r e e o f w h o m w e r e f a c u l t y m e m b e r s i n a d u l t e d u c a t i o n a n d c o n t i n u i n g n u r s i n g e d u c a t i o n . T h e r e m a i n i n g e i g h t w e r e g r a d u a t e s t u d e n t s i n a d u l t e d u c a t i o n . T h e s e c o n d p h a s e c o n s i s t e d o f a n a c t u a l p i l o t s t u d y o f t h e i n s t r u m e n t u s i n g a g r o u p o f t e n r e g i s t e r e d n u r s e s . F o u r o f t h e s e n u r s e s w e r e c u r r e n t l y e m p l o y e d a t t h e H e a l t h S c i e n c e s C e n t r e H o s p i t a l - D e p a r t m e n t o f P s y c h i a t r y , U n i v e r s i t y o f B r i t i s h C o l u m b i a , t h e o t h e r s w e r e p o s t - b a s i c s t u d e n t s i n t h e b a c c a l a u r e a t e p r o g r a m a t t h e S c h o o l o f N u r s i n g , U n i v e r s i t y o f B r i t i s h C o l u m b i a . T h e s e s i x n u r s e s w e r e e i t h e r c u r r e n t l y o r r e c e n t l y e m p l o y e d i n v a r i o u s h o s p i t a l s i n t h e G r e a t e r V a n c o u v e r a r e a a n d t h e r e f o r e w e r e r e p r e s e n t a t i v e o f t h e p o p u l a t i o n i d e n t i f i e d i n t h i s s t u d y . T h e q u e s t i o n n a i r e w a s r e v i s e d f o l l o w i n g p r e t e s t i n g . W h i l e t h e f o r m a t o f t h e i n s t r u m e n t w a s a l t e r e d s o m e w h a t , a n d c e r t a i n d i r e c t i o n s c l a r i f i e d , t h e q u e s t i o n s r e m a i n e d b a s i c a l l y u n c h a n g e d . A c o d i n g c o l u m n w a s a d d e d t o p e r m i t k e y p u n c h i n g d i r e c t l y f r o m t h e q u e s t i o n n a i r e s . D A T A C O L L E C T I O N A N D D E S C R I P T I O N O F T H E S A M P L E R e c o g n i z i n g t h e l i m i t a t i o n s o f m a i l e d q u e s t i o n n a i r e s ( 2 7 ) , i t w a s i n i t i a l l y d e c i d e d t h a t t h e s u r v e y i n s t r u m e n t w o u l d b e p e r s o n a l l y a d m i n i s t e r e d i n s c h e d u l e d g r o u p s e s s i o n s . T h e s a m p l e w a s i n v i t e d b y l e t t e r t o a t t e n d o n e of three group sessions scheduled for each hospital (one of two sessions at Burnaby General Hospital). It was anticipated that personal administration of the questionnaire would ensure a more complete and higher rate of return. A total of fourteen group administrations were conducted between November 19, 1973 and December 12, 1973. Since only 132 responses (52.8%) were obtained at the conclusion of this period i t was necessary to revert to a mailing procedure to collect the remaining data. A copy of the ques-tionnaire and a stamped addressed envelope was distributed to each of the potential respondents who had not been able to attend a group session. By January 15, 1974 an additional 110 completed questionnaires (44.0%) had been received. Hence the total response rate was 96.8 percent. This particularly high rate of return was achieved through the use of replacement names. The 242 completed questionnaires represent 70.6 per-cent of the 343 potential respondents. As a result of the replacement procedure, a return rate greater than 100 percent was obtained from two of the hospitals (Burnaby General Hospital - 123.3%, Surrey Memorial Hospital -140.5%). In order to retain the proportional distribution of the sample, 22 responses were discarded according to the original l i s t of extra random numbers. This produced the following f i n a l response rate for each hospital: Burnaby General Hospital - 30 (100%), Lion's Gate Hospital - 50 (86.2%), Royal Columbian Hospital - 55 (91.7%), St. Paul's Hospital - 48 (73.8%), and Surrey Memorial Hospital - 37 (100.0%) for a total of 220 or 88.0 percent. No formal attempt.was made to contact those potential respondents who did not participate in either the group sessions nor the mailed question-naire. Informal discussions with some of the nurses and the hospitals' administrative nursing personnel indicate the following reasons for the lack o f a t t e n d a n c e a t t h e g r o u p s e s s i o n s : 1 . " J u s t p l a i n f o r g o t . I n t e n t i o n s w e r e g o o d , b u t ! 2 . T i m e s n o t s u i t a b l e t o t h o s e o n s h i f t , e s p e c i a l l y n i g h t s h i f t . 3 . T h o s e w i t h f a m i l i e s a n d o n s h i f t d u t y h a d d i f f i -c u l t y a r r a n g i n g b a b y s i t t e r s " ( 1 6 ) . 4 . P a r t - t i m e n u r s e s n o t o n d u t y o n t h e d a y s s c h e d u l e d f o r g r o u p s e s s i o n s . 5 . N u r s e s o n h o l i d a y s o r l e a v e - o f - a b s e n c e w i l l i n g t o c o m p l e t e m a i l e d q u e s t i o n n a i r e a t h o m e b u t n o t a t t e n d g r o u p s e s s i o n s . T h e g r e a t e r r e s p o n s e ( 5 5 . 3 % ) t o t h e m a i l e d q u e s t i o n n a i r e a s c o m p a r e d w i t h t h e 3 8 . 5 p e r c e n t a t t e n d a n c e a t t h e g r o u p s e s s i o n s ( p e r c e n t a g e s c a l c u l a t e d o n t h e b a s i s o f 1 9 9 d i s t r i b u t e d q u e s t i o n n a i r e s a n d 3 4 3 p o t e n t i a l r e s p o n d e n t s r e s p e c t i v e l y ) s u g g e s t s t h a t m a i l e d q u e s t i o n n a i r e s m a y b e a p r e f e r r e d m e t h o d o f d a t a c o l l e c t i o n f o r n u r s i n g p o p u l a t i o n s . T h i s u n e x p e c t e d f i n d i n g m e r i t s f u r t h e r i n v e s t i g a t i o n a n d h a s c o n s i d e r a b l e i m p o r t f o r t h e e c o n o m i c a l a n d e f f i c i e n t i m p l e m e n t a t i o n o f f u t u r e s u r v e y r e s e a r c h i n n u r s i n g . D A T A A N A L Y S I S T h e d a t a o n 2 2 0 c o m p l e t e d q u e s t i o n n a i r e s w e r e c o d e d , c h e c k e d , a n d d i r e c t l y k e y p u n c h e d o n t o c o m p u t e r c a r d s . T h e U n i v e r s i t y o f B r i t i s h C o l u m b i a C o m p u t i n g C e n t e r ' s M V T A B , T R I P , B M D 0 1 D , C O R N , a n d F A N p r o g r a m s w e r e u s e d t o a n a l y z e t h e d a t a . C h a r a c t e r i s t i c s o f t h e S a m p l e U n i v a r i a t e a n d b i v a r i a t e t a b l e s w e r e c o n s t r u c t e d t o a r r i v e a t 3 8 . f r e q u e n c y d i s t r i b u t i o n s o f t h e v a r i o u s s o c i o - e c o n o m i c c h a r a c t e r i s t i c s o f t h e s a m p l e . M e a n s , s t a n d a r d d e v i a t i o n s , m i n i m u m s , m a x i m u m s , r a n g e s , n u m b e r s a n d p e r c e n t a g e d i s t r i b u t i o n s w e r e c o m p u t e d w h e r e a p p r o p r i a t e . T h e C h i - s q u a r e s t a t i s t i c w a s c a l c u l a t e d a t t h e . 0 5 l e v e l o f s i g n i f i c a n c e t o t e s t d i f f e r e n c e s i n t h e d i s t r i b u t i o n s b e t w e e n g r o u p s o n s e l e c t e d c h a r a c t e r i s t i c s . T e s t i n g t h e H y p o t h e s e s T h e f r e q u e n c y d i s t r i b u t i o n s t o g e t h e r w i t h m e a n s , s t a n d a r d d e v i a t i o n s , m i n i m u m s , m a x i m u m s a n d o r r a n g e s o f s c o r e s o n t h e t o t a l p a r t i c i p a t i o n i n d e x a n d t h e s u b - i n d e x e s o f p a r t i c i p a t i o n i n i n d e p e n d e n t a n d . d e p e n d e n t l e a r n i n g a c t i v i t i e s w e r e c o m p u t e d . T h e n t h e f r e q u e n c y a n d p e r c e n t a g e d i s t r i b u t i o n s o f n u r s e s ' p a r t i c i p a t i o n i n e a c h a c t i v i t y i n t h e i n d e x o v e r t h e p a s t y e a r w e r e t a b u l a t e d . A t - t e s t ( p a i r e d c o m p a r i s o n ) w a s u s e d t o d e t e r m i n e i f t h e d i f f e r e n c e b e t w e e n s c o r e s o n t h e i n d e p e n d e n t a n d d e p e n d e n t l e a r n i n g a c t i v i t y i n d e x e s w a s s i g n i f i c a n t a t t h e . 0 5 l e v e l ( 7 ) . T h e d a t a f r o m t h e 5 8 i t e m L e a r n i n g O r i e n t a t i o n I n d e x w e r e s u b j e c t e d t o f a c t o r a n a l y s i s u s i n g p r i n c i p l e c o m p o n e n t s m e t h o d o f a n a l y s i s w i t h v a r i m a x r o t a t i o n s . ( 2 7 , 2 3 ) • F a c t o r s c o r e s w e r e c o m p u t e d f o r e v e r y i n d i v i d u a l o n e a c h f a c t o r . P e a r s o n ' s p r o d u c t - m o m e n t c o e f f i c i e n t o f c o r r e l a t i o n ( r ) w a s u s e d t o t e s t f o r s i g n i f i c a n t r e l a t i o n s h i p s b e t w e e n t h e r e s p o n d e n t s ' f a c t o r s c o r e s o n e a c h m a j o r f a c t o r a n d t h e i r s c o r e s o n t h e p a r t i c i p a t i o n i n d e x e s ( t o t a l , i n d e p e n d e n t , a n d d e p e n d e n t ) . I n o r d e r t o c o m p u t e t h i s a n d s u b s e q u e n t c o e f f i c i e n t s o f c o r r e l a t i o n t h e t w o d e p e n d e n t v a r i a b l e s , e x t e n t o f p a r t i c i p a t i o n i n i n d e p e n d e n t a n d t d e p e n d e n t t y p e a c t i v i t i e s , w e r e t r a n s f o r m e d i n t o p e r c e n t a g e s o f t h e t h i r d 39 dependent v a r i a b l e , t o t a l r a t e of p a r t i c i p a t i o n . This ensured that the study of the i n f l u e n c e of c e r t a i n p s y c h o l o g i c a l and socio-economic f a c t o r s on d i f f e r e n t kinds of p a r t i c i p a t i o n was based upon the p r o p o r t i o n s to which nurses engage i n these two types of l e a r n i n g a c t i v i t i e s and was not biased by the l e v e l of t h e i r t o t a l involvement over the past year. Nurses' a t t i t u d e to c o n t i n u i n g n u r s i n g education was analyzed by c a l c u l a t i n g the frequency d i s t r i b u t i o n together w i t h mean, standard d e v i -a t i o n , minimum, maximum and range of t h e i r scores on the a t t i t u d e s c a l e . These scores were c o r r e l a t e d w i t h the s e l f - r a t i n g s c a l e scores to provide a t e s t of content v a l i d i t y . The i n f l u e n c e of nurses' a t t i t u d e to c o n t i n u i n g n u r s i n g education and f o u r t e e n s p e c i f i c socio-economic c h a r a c t e r i s t i c s (age, m a r i t a l s t a t u s , t o t a l number of c h i l d r e n , number of preschool c h i l d r e n , number of elementary school c h i l d r e n , number of secondary school c h i l d r e n , b a s i c n u r s i n g education, u n i v e r s i t y education, number of years s i n c e grad-u a t i o n , number of years a c t i v e n u r s i n g p r a c t i c e , number of years not p r a c t i c i n g as a nurse, l e n g t h of employment i n c u r r e n t h o s p i t a l , employment s t a t u s , and p o s i t i o n ) on t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s was i n v e s t i g a t e d u s i n g v a r i o u s c o e f f i c i e n t s of c o r r e l a t i o n . A m u l t i p l e r e g r e s s i o n a n a l y s i s procedure was used to determine the power w i t h which these'same socio-economic f a c t o r s , the nurses' a t t i t u d e to c o n t i n u i n g n u r s i n g education, and the nurses' l e a r n i n g o r i e n t a t i o n s p r e d i c t e d t h e i r p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s . 4 0 L I M I T A T I O N S I n a s m u c h a s t h e p o p u l a t i o n o f t h i s s t u d y w a s r e s t r i c t e d t o f e m a l e r e g i s t e r e d n u r s e s e m p l o y e d o n a f u l l — o r p a r t - t i m e b a s i s b y f i v e s e l e c t e d G r e a t e r V a n c o u v e r a r e a g e n e r a l h o s p i t a l s , a n y g e n e r a l i z a t i o n s b e y o n d t h e s e p a r a m e t e r s m u s t b e m a d e w i t h c a u t i o n . I n a d d i t i o n , t h e s u r v e y i n s t r u m e n t e l i c i t e d o n l y s e l f - r e p o r t e d d a t a , t h e r e b y r e n d e r i n g t h e f i n d i n g s d e p e n d e n t u p o n t h e a c c u r a c y o f e a c h o f t h e r e s p o n d e n t ' s r e c a l l a n d p e r c e p t i o n . T w o m a j o r s e c t i o n s o f t h e q u e s t i o n n a i r e ( P a r t i c i p a t i o n I n d e x a n d L e a r n i n g O r i e n -t a t i o n I n d e x ) c o l l e c t e d d a t a a b o u t n u r s e s ' c o n t i n u o u s l e a r n i n g a c t i v i t i e s o v e r a n a r b i t r a r i l y s e t t i m e p e r i o d , f r o m S e p t e m b e r 1 , 1 9 7 2 t o S e p t e m b e r 3 0 , 1 9 7 3 . T h e g e n e r a l i n t e r p r e t a t i o n o f r e s u l t s i s t h e r e f o r e l i m i t e d i n t h a t n o a t t e m p t w a s m a d e t o e s t a b l i s h w h e t h e r n u r s e s ' i n v o l v e m e n t i n e d u c a t i o n a l a c t i v i t i e s d u r i n g t h e s e t w e l v e m o n t h s w a s t y p i c a l o r r e p r e s e n t a t i v e o f t h e i r u s u a l p a r t i c i p a t i o n p a t t e r n s . I t m u s t b e a s s u m e d a l s o t h a t e r r o r s o f m e a -s u r e m e n t o c c u r i n e a c h p a r t o f t h e q u e s t i o n n a i r e . S U M M A R Y T h i s c h a p t e r h a s d e f i n e d t h e p o p u l a t i o n t o b e s t u d i e d a n d o u t l i n e d t h e p r o c e d u r e s u s e d t o a c q u i r e a n a p p r o p r i a t e r a n d o m s a m p l e . T h e s u r v e y i n s t r u m e n t , a q u e s t i o n n a i r e , w a s d e s c r i b e d i n t e r m s o f i t s d e v e l o p m e n t , t e s t i n g a n d r e v i s i o n . T h e t w o m e t h o d s o f d a t a c o l l e c t i o n w e r e a c c o u n t e d f o r i n a d i s c u s s i o n o f t h e n a t u r e a n d r a t e o f r e s p o n s e . T h e p l a n f o r a n a -l y z i n g t h e d a t a w a s f o l l o w e d b y a n i d e n t i f i c a t i o n o f t h e s t u d y ' s l i m i t a t i o n s . C H A P T E R I V F I N D I N G S T h i s c h a p t e r h a s b e e n o r g a n i z e d s o a s t o p r e s e n t t h e r e s u l t s a c c o r d i n g t o t h e m a j o r a r e a s o f i n t e r e s t t o t h e s t u d y a n d i n s u c h a w a y a s t o d e a l s y s t e m a t i c a l l y w i t h t h e v a r i o u s h y p o t h e s e s . I n i t i a l l y t h e r e s p o n -d e n t s w i l l b e d e s c r i b e d i n t e r m s o f t h e i r s o c i o - e c o n o m i c c h a r a c t e r i s t i c s . A n y s i g n i f i c a n t d i f f e r e n c e s b e t w e e n t h e g r o u p s o f n u r s e s e m p l o y e d b y t h e f i v e h o s p i t a l s a n d t h o s e r e s p o n d i n g t o t h e q u e s t i o n n a i r e e i t h e r i n t h e g r o u p s e s s i o n s o r b y m a i l a r e r e p o r t e d , t h e n t h e f i n d i n g s p e r t i n e n t t o t h e e x t e n t a n d n a t u r e o f t h e r e s p o n d e n t s ' p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s a r e d i s c u s s e d . T h i s i s f o l l o w e d b y a r e p o r t o n t h e r e s p o n d e n t s ' l e a r n i n g o r i e n t a t i o n s a c c o m p a n i e d b y a c o m p a r i s o n o f t h e s e r e s u l t s w i t h t h o s e o f p r e v i o u s s t u d i e s . S u b s e q u e n t l y , t h e r e s p o n s e s t o t h e c o n t i n u i n g n u r s i n g e d u c a t i o n a t t i t u d e s c a l e a r e r e p o r t e d , a n d f i n a l l y , t h e r e i s a d i s c u s s i o n o f t h e r e l a t i o n s h i p o f t h e v a r i o u s p s y c h o l o g i c a l a n d s o c i o -e c o n o m i c f a c t o r s t o t h e n u r s e s ' r a t e s o f p a r t i c i p a t i o n . S O C I O - E C O N O M I C C H A R A C T E R I S T I C S O F T H E S A M P L E A g e a n d M a r i t a l S t a t u s T h e r e s p o n d e n t s r a n g e d i n a g e f r o m 2 0 t o 6 3 y e a r s w i t h t h e a v e r a g e 4 1 42 age being 33.7 and the standard deviation 10.6 (Table 2). Forty-three per-cent of the respondents were less than 30 years of age while those 50 years or more accounted for ten percent of the sample. There was a significant difference i n the age distribution among the five hospital groups 2 (X = 21.37, df = 12, p = .04500). Royal Columbian and St. Paul's Hospitals accounted for over 56.4 percent of the 94 respondents under 30 years of age, whereas 65.2 percent of the older age group (50 years or more) came from Burnaby General and Lion's Gate Hospitals. More than half of the respondents (53.2%) were married, 34.1 percent were single, and 12.7 percent were either separated, widowed or divorced (Table 3). When testing the differences in the marital status distributions of the respondents in the five hospitals, the chi-square value obtained 2 was s t a t i s t i c a l l y significant (x = 27.74, df = 8, p = .00058). A l l the hospitals had more married nurses represented in the sample except St. Paul's Hospital where 62.5 percent of the respondents were single. Number of Children Sixty percent (132) of the respondents reported having no children. Most of the other 88 nurses (56.0%) had either two or three children. Only twenty of the respondents with children (22.7%) reported having preschoolers, 39 (44.3%) had children in elementary school, and 42 (47.7%) had children enrolled in secondary schools. The total percentage exceeds 100 percent due to the fact that a number of the respondents had children of different ages involved in various levels of schooling. 4 3 T a b l e 2 S u m m a r y T a b l e o f S o c i o - E c o n o m i c C h a r a c t e r i s t i c s o f R e s p o n d e n t s ( I n t e r v a l D a t a ) C h a r a c t e r i s t i c s M e a n S . D , R a n g e A g e 3 3 . 7 3 1 0 . 6 4 2 0 - 6 3 T o t a l n u m b e r o f C h i l d r e n 1 . 0 5 1 . 5 1 0 - 6 N u m b e r o f p r e s c h o o l c h i l d r e n 0 . 1 1 0 . 3 7 0 - 2 N u m b e r o f c h i l d r e n i n e l e m e n t a r y s c h o o l 0 . 2 7 0 . 6 5 0 - 3 N u m b e r o f c h i l d r e n i n s e c o n d a r y s c h o o l Y e a r s s i n c e g r a d u a t i o n Y e a r s o f a c t i v e n u r s i n g p r a c t i c e Y e a r s n o t p r a c t i c i n g a s a n u r s e 0 . 3 7 1 1 . 7 6 9 . 3 5 2 . 4 4 0 . 8 6 1 0 . 1 7 8 . 1 2 4 . 9 3 0 - 4 0 - 3 9 0 - 3 3 0 - 2 8 L e n g t h o f e m p l o y m e n t i n c u r r e n t h o s p i t a l ( y e a r s ) 4 . 2 5 5 . 3 9 0 . 2 5 - 3 3 H o u r s w o r k e d p e r w e e k 3 6 . 9 3 5 . 0 3 1 2 - 4 8 P e r c e n t a g e o f w o r k t i m e s p e n t s u p e r v i s i n g o t h e r n u r s i n g s t a f f 4 0 . 2 0 2 9 . 9 3 0 - 1 0 0 T a b l e 3 S u m m a r y T a b l e o f S o c i o - E c o n o m i c C h a r a c t e r i s t i c s o f R e s p o n d e n t s ( N o m i n a l D a t a ) C h a r a c t e r i s t i c N u m b e r P e r c e n t a g e M a r i t a l S t a t u s S i n g l e 7 5 3 4 . 0 9 M a r r i e d 1 1 7 5 3 . 1 8 O t h e r : s e p a r a t e d , d i v o r c e d , w i d o w e d 2 8 1 2 . 7 3 N o R e s p o n s e 0 0 . 0 0 T O T A L 2 2 0 1 0 0 . 0 0 I n i t i a l E d u c a t i o n a l P r e p a r a t i o n i n N u r s i n g H o s p i t a l d i p l o m a p r o g r a m 1 9 6 8 9 . 0 9 D i p l o m a p r o g r a m s p o n s o r e d b y a p o s t -s e c o n d a r y e d u c a t i o n a l i n s t i t u t i o n 1 5 6 . 8 2 B a c c a l a u r e a t e d e g r e e p r o g r a m 5 2 . 2 7 N o R e s p o n s e 4 1 . 8 2 T O T A L 2 2 0 1 0 0 . 0 0 U n i v e r s i t y E d u c a t i o n a l E x p e r i e n c e U n i v e r s i t y e d u c a t i o n 3 9 1 7 . 7 3 N o u n i v e r s i t y e d u c a t i o n 1 8 0 8 1 . 8 2 N o R e s p o n s e 1 . 4 5 T O T A L 2 2 0 1 0 0 . 0 0 E m p l o y m e n t S t a t u s ' F u l l - t i m e 2 0 4 9 2 . 7 3 P a r t - t i m e 1 6 7 . 2 7 N o R e s p o n s e 0 0 . 0 0 T O T A L 2 2 0 1 0 0 . 0 0 T a b l e 3 ( c o n t i n u e d ) C h a r a c t e r i s t i c N u m b e r P e r c e n t a g e P o s i t i o n S t a f f N u r s e 1 8 0 8 1 . 8 2 H e a d N u r s e o r A s s i s t a n t H e a d N u r s e 2 3 1 0 . 4 5 S u p e r v i s o r 9 4 . 0 9 O t h e r 8 3 . 6 4 N o R e s p o n s e 0 0 . 0 0 T O T A L 2 2 0 1 0 0 . 0 0 C l i n i c a l S p e c i a l t y M e d i c a l - S u r g i c a l 7 2 3 2 . 7 3 O b s t e t r i c s / G y n e c o l o g y 3 1 1 4 . 0 9 P e d i a t r i c s 1 9 8 . 6 4 P s y c h i a t r y 3 1 . 3 6 E x t e n d e d C a r e / G e r i a t r i c s 1 2 5 . 4 5 A c u t e C a r e ( I . C . U . , C . C . U . , E m e r g . , O . R . / P . A . R . ) 4 5 2 0 . 4 5 O t h e r 2 9 1 3 . 1 8 N o R e s p o n s e 9 4 . 0 9 T O T A L 2 2 0 1 0 0 . 0 0 46 E d u c a t i o n a l B a c k g r o u n d M o s t o f t h e r e s p o n d e n t s (89.1%) i n d i c a t e d t h a t t h e y h a d r e c e i v e d t h e i r i n i t i a l n u r s i n g e d u c a t i o n f r o m h o s p i t a l d i p l o m a p r o g r a m s . O n l y f i f t e e n (6.8%) o f t h e n u r s e s s a m p l e d h a d g r a d u a t e d f r o m t h e n e w e r d i p l o m a p r o g r a m s s p o n s o r e d b y e d u c a t i o n a l i n s t i t u t i o n s s u c h a s t e c h n i c a l s c h o o l s a n d c o m m u n i t y c o l l e g e s , a n d e v e n f e w e r (2.3%) h a d g r a d u a t e d f r o m a b a c c a l a u r e a t e p r o g r a m a s t h e i r i n i t i a l p r e p a r a t i o n i n n u r s i n g . T h i r t y - f o u r o f t h e r e s p o n d e n t s r e p o r t e d h a v i n g a d d i t i o n a l u n i v e r s i t y e d u c a t i o n i n e i t h e r n u r s i n g o r n o n - n u r s i n g s u b j e c t s . M o s t o f t h e s e w e r e h o s -p i t a l g r a d u a t e s w h o a p p e a r e d t o h a v e t a k e n t h e i r p o s t - b a s i c d e g r e e i n o r d e r t o u p g r a d e t h e i r q u a l i f i c a t i o n s . T h e r e f o r e , a t o t a l o f 39 (17.7%) o f t h e r e s p o n d e n t s h a d r e c e i v e d s o m e u n i v e r s i t y e d u c a t i o n , w h i l e 180 (81.8%) h a d n o t . Y e a r s o f N u r s i n g P r a c t i c e T h e n u m b e r o f y e a r s s i n c e g r a d u a t i o n r a n g e d f r o m z e r o (1973 g r a d u a t e s ) t o 39, w i t h a m e a n o f 11.8 y e a r s a n d a s t a n d a r d d e v i a t i o n o f 10.2. T h e r e s p o n -d e n t s r e p o r t e d a c t i v e l y p r a c t i c i n g f r o m z e r o t o 33 y e a r s w i t h a n a v e r a g e o f 9.4 y e a r s a n d a s t a n d a r d d e v i a t i o n o f 8.1. M o s t o f t h e n u r s e s (39.5%) w e r e f a i r l y r e c e n t g r a d u a t e s h a v i n g p r a c t i c e d z e r o t o f o u r y e a r s . T h e r e m a i n i n g r e s p o n d e n t s w e r e g e n e r a l l y e v e n l y d i s t r i b u t e d o v e r t h e o t h e r f o u r c a t e g o r i e s o f y e a r s o f a c t i v e n u r s i n g p r a c t i c e e v e n t h o u g h t h e p e r c e n t a g e s r e f l e c t a g r a d u a l d e c l i n e (5-9 y e a r s = 18.6%, 10-14 y e a r s = 16.8%, 15-19 y e a r s = 12.7% a n d 20 y e a r s o r m o r e = 12.3%). W h e n t e s t i n g t h e d i f f e r e n c e s i n t h e d i s t r i b u -t i o n o f t h e r e s p o n d e n t s ' y e a r s o f a c t i v e n u r s i n g p r a c t i c e i n t h e f i v e h o s p i t a l s 2 a s t a t i s t i c a l l y s i g n i f i c a n t c h i - s q u a r e v a l u e w a s o b t a i n e d (x = 26.78, d f = 16, p = .04391). T h e n u r s e s f r o m R o y a l C o l u m b i a n a n d S t . P a u l ' s H o s p i t a l s a c c o u n t e d for 56.3 percent of the respondents having practiced zero to four years. The sample of nurses from Lion's Gate Hospital had more in the 5 to 9 and 10 to 14 year groups than any of the other agencies. Forty-four percent of the nurses who had practiced twenty years or more came from Royal Columbian Hospital reflecting the rather polar distribution of Royal Columbian nurses on this particular variable. Despite the fact that 38.6 percent of the respondents had graduated fifteen or more years ago, only 17.7 percent of the total sample, had not been practicing nursing for five years or more. Those respondents (81.4%) who had been absent from the nursing labour force for zero to four years for one reason or another were quite evenly distributed among the five study hospitals. These findings reflect a highly active labour force among this particular sample of registered nurses. Length of Current Employment The length of time that the respondents reported being employed in their present hospital varied from approximately three months to 33 years with a mean of 4.2 years and a standard deviation of 5.4 years. More than one-quarter of the sample had been employed less than twelve months, almost 60 percent (59.1%) less than three years, while 28 (12.7%) had worked in the same hospital ten years or more. Employment Status and Position A large majority of the nurses sampled (92.7%) were employed f u l l -time. This 9 to 1 ratio of full-time to part-time employees occurred in a l l 4 8 o f t h e f i v e h o s p i t a l s . T h e s a m p l i n g o f p a r t - t i m e n u r s e s w a s l o w e r t h a n e x p e c t e d t h e r e b y s k e w i n g t h e r e s u l t s o f t h e i n t e r v a l m e a s u r e o f t h e n u m b e r o f h o u r s w o r k e d p e r w e e k ( m e a n = 3 6 . 9 , S . D . 5 . 0 3 ) . I t w a s t h e r e f o r e d e c i d e d t o e l i m i n a t e t h i s v a r i a b l e f r o m s u b s e q u e n t a n a l y s e s . A s a n t i c i p a t e d , m o s t o f t h e n u r s e s i n t h e s a m p l e ( 8 1 . 8 % ) w e r e s t a f f n u r s e s . T e n p e r c e n t o f t h e t o t a l g r o u p w e r e a s s i s t a n t h e a d o r h e a d n u r s e s , 4 . 1 p e r c e n t w e r e s u p e r v i s o r s , a n d t h e r e m a i n i n g 3 . 6 p e r c e n t ' o t h e r s ' i n c l u d e d e d u c a t o r s , a d i r e c t o r o f n u r s i n g , a s w e l l a s a f e w w h o s e p o s i t i o n s c o u l d n o t b e r e a d i l y c l a s s i f i e d . W h i l e t h e a m o u n t o f w o r k - t i m e s p e n t s u p e r v i s i n g o t h e r n u r s i n g s t a f f r a n g e d f r o m z e r o t o 1 0 0 p e r c e n t , t h e m e a n w a s 4 0 . 2 p e r c e n t w i t h a s t a n d a r d d e v i a t i o n o f 2 9 . 9 . T h i s w i d e v a r i a t i o n i n t h e f i n d i n g s w a s a l s o r e f l e c t e d i n a n a n a l y s i s o f t h e s a m e g r o u p e d d a t a . W h i l e m o r e o f t h e r e s p o n d e n t s ( 6 3 ) t h o u g h t t h e y s u p e r v i s e d o t h e r n u r s i n g s t a f f 0 - 2 4 p e r c e n t o f t h e i r w o r k i n g t i m e , t h e d i s t r i b u t i o n a c r o s s t h e t h r e e r e m a i n i n g c a t e g o r i e s w a s e s s e n t i a l l y u n i f o r m ( 2 5 - 4 9 % = 3 7 , 5 0 - 7 4 % = 3 7 , 7 5 - 1 0 0 % = 3 9 ) . D u r i n g t h e a d m i n i s t r a t i o n o f t h e q u e s t i o n n a i r e , t h i s i t e m a p p e a r e d t o p o s e t h e m o s t d i f f i c u l t y . T h i s w a s s u b s e q u e n t l y a f f i r m e d b y t h e f a c t t h a t t h i s p a r t i c u l a r q u e s t i o n r e c e i v e d t h e h i g h e s t n o n - r e s p o n s e r a t e ( 2 0 . 0 % ) . I t w a s c o n c l u d e d t h a t t h i s w a s a n i n v a l i d i t e m a n d t h e r e f o r e t h e d a t a w a s e x c l u d e d f r o m f u r t h e r s t a t i s t i c a l a n a l y s e s . C l i n i c a l S p e c i a l t y T h e v a l i d i t y o f t h e r e s p o n s e s t o t h i s i t e m i s a l s o s o m e w h a t s u s p e c t a s s o m e o f t h e r e s p o n d e n t s i n d i c a t e d t h e i r p r e f e r r e d a r e a o f n u r s i n g p r a c t i c e r a t h e r 49 than the specialty within which they were currently working. Nevertheless, the responses were tabulated for the purpose of describing the sample. One-third of the nurses recorded medical-surgical nursing as their c l i n i c a l specialty. The other two-thirds distributed across the remaining categories according to the following rates of frequency: acute care - 20.1%, obstetrics - 14.1%, pediatrics - 8.6%, extended care/geriatrics - 5.5% and psychiatry -1.2%. Twenty-nine nurses (13.2%) such as 'floats' and I.V. therapists could not be categorized and were therefore tabulated as 'others'. Discussion The 'typical' registered nurse employed in any one of the five hospitals included in this study was 34 years of age, married, with two children. She graduated from a hospital diploma program within the last four years (1970-1973) and was employed full-time as a staff nurse on a medical-surgical service. She had actively practiced as a nurse since completing her basic professional education and had worked most of that time in her current employing agency. While the groups of nurses drawn from the five hospitals did not dif f e r with respect to many of the socio-economic characteristics, three significant chi-squares were obtained ( frequency distributions of nurses according to age, marital status and the number of years of active nursing practice). These factors are undoubtedly interrelated and the differences among agencies can be pa r t i a l l y explained by the location of the hospitals and the nature of the communities from which they primarily draw their employees. Situated on the boundary of the West End, an area densely populated by a high percentage of young, single, mobile people, St. Paul's Hospital understandably had the 50 h i g h e s t p r o p o r t i o n o f u n m a r r i e d n u r s e s u n d e r 30 y e a r s o f a g e . I t f o l l o w s t h a t t h e s e n u r s e s w o u l d b e r e l a t i v e l y r e c e n t g r a d u a t e s w h o h a d n o t p r a c t i c e d n u r s i n g f o r a l e n g t h y p e r i o d o f t i m e ( l e s s t h a n 4 y e a r s ) . T h e r e m a i n i n g f o u r h o s p i t a l s a r e s i t u a t e d i n p r e d o m i n e n t l y s i n g l e f a m i l y d w e l l i n g s u b u r b a n a r e a s , h e n c e m o r e o f t h e i r n u r s e s a r e m a r r i e d . S u r r e y , w h i c h i s a m o r e r e c e n t l y d e v e l o p e d r e s i d e n t i a l c o m m u n i t y , s u p p o r t s a y o u n g e r n u r s i n g l a b o u r f o r c e t h a n d o t h e m o r e e s t a b l i s h e d a r e a s o f B u r n a b y a n d N o r t h V a n c o u v e r w h e r e L i o n ' s G a t e H o s p i t a l i s s i t u a t e d . T h e c o m m u n i t y s u r r o u n d i n g R o y a l C o l u m b i a n H o s p i t a l c a n -n o t b e d e s c r i b e d a s s i m p l y a s t h e o t h e r s . T h e h e t e r o g e n o u s c h a r a c t e r o f N e w W e s t m i n s t e r i s r e f l e c t e d i n t h e m o r e e v e n l y d i s t r i b u t e d a g e g r o u p s o f t h e r e s p o n d e n t s f r o m t h a t a g e n c y . W h i l e m o r e t h a n h a l f o f t h e s e n u r s e s w e r e m a r -r i e d , 41.8 p e r c e n t o f t h e m h a d p r a c t i c e d n u r s i n g f o r l e s s t h a n f i v e y e a r s a n d 21.8 p e r c e n t f o r t w e n t y y e a r s o r m o r e . I n a d d i t i o n t o t e s t i n g t h e s o c i o - e c o n o m i c d a t a f o r d i f f e r e n c e s a m o n g t h e f i v e h o s p i t a l g r o u p s , c h i - s q u a r e s w e r e o b t a i n e d o n t h e b i v a r i a t e a n a l y s e s o f t h e s a m e d a t a b y t h e t w o t y p e s o f q u e s t i o n n a i r e r e s p o n s e , g r o u p s e s s i o n s a n d m a i l e d . T h e o n l y v a r i a b l e t h a t e m e r g e d a s s i g n i f i c a n t l y d i f f e r e n t w a s 2 t h e u n i v e r s i t y e d u c a t i o n a l e x p e r i e n c e f a c t o r (x = 4.80, d f = 1 , p = .02689). R e g i s t e r e d n u r s e s w i t h o u t a n y u n i v e r s i t y p r e p a r a t i o n r e s p o n d e d i n a p p r o x i m a t e l y e q u a l p r o p o r t i o n s i n t h e g r o u p s e s s i o n s a n d b y t h e m a i l e d q u e s t i o n n a i r e (39.5% a n d 42.3% r e s p e c t i v e l y ) . I n c o n t r a s t , 6.8 p e r c e n t m o r e n u r s e s w i t h u n i v e r s i t y e d u c a t i o n p a r t i c i p a t e d i n t h e g r o u p a d m i n i s t e r e d q u e s t i o n n a i r e s t h a n t h e m a i l e d i n s t r u m e n t s . T h i s d i f f e r e n c e c a n n o t b e r e a d i l y e x p l a i n e d . I t m a y b e t h a t t h e s e n u r s e s a r e m o r e o f t e n i n d a y s h i f t , l e a d e r s h i p p o s i t i o n s a n d c o u l d t h e r e -f o r e m o r e e a s i l y a t t e n d t h e g r o u p s e s s i o n s s c h e d u l e d b e t w e e n 1430 a n d 1730 h o u r s . 5 1 Due to the few apprec iab le d i f f erences between the f i v e h o s p i t a l groups and the two types of ques t ionnaire response, i t was considered j u s -t i f i a b l e to t r e a t the 2 2 0 respondents as a t o t a l group and to proceed with the d e s c r i p t i v e a n a l y s i s and t e s t i n g of hypotheses a c c o r d i n g l y . PARTICIPATION IN CONTINUING LEARNING ACTIVITIES T o t a l P a r t i c i p a t i o n Each of the 2 2 0 respondents p a r t i c i p a t e d i n at l e a s t one of the 2 2 i temized cont inu ing l e a r n i n g a c t i v i t i e s dur ing the per iod between September 1 , 1 9 7 2 and September 3 0 , 1 9 7 3 . Table 4 shows a mean t o t a l p a r t i c i p a t i o n score of 9 . 9 i n d i c a t i n g that the respondents engaged i n l e s s than one-ha l f ( 1 1 ) of the se lec ted l e a r n i n g a c t i v i t i e s . While the t o t a l p a r t i c i p a t i o n score ranged from one to seventeen, 6 8 . 3 percent of the respondents p a r t i c i p a t e d i n seven to t h i r t e e n of the a c t i v i t i e s over the twelve month p e r i o d . Table 4 P a r t i c i p a t i o n i n Cont inuing Learning A c t i v i t i e s f o r Nurses Index Mean S .D. Range T o t a l p a r t i c i p a t i o n index 9 . 9 1 2 . 8 6 1-17 Independent sub-index 5 . 5 0 1 . 7 0 1-9 Dependent sub-index 4 . 4 2 1 . 6 3 0 - 9 t = 9 . 3 8 , df = 2 1 9 , p = . 0 0 0 0 0 5 2 I n d e p e n d e n t L e a r n i n g A c t i v i t i e s T h e s c o r e s o n t h e i n d e p e n d e n t l e a r n i n g a c t i v i t y s u b - i n d e x r a n g e d f r o m o n e t o n i n e w i t h a m e a n o f 5 . 5 a n d a s t a n d a r d d e v i a t i o n o f 1 . 7 , h e n c e t w o - t h i r d s o f t h e r e s p o n d e n t s h a d b e e n i n v o l v e d i n f o u r t o s e v e n o f t h e l e a r n i n g a c t i v i t i e s j u d g e d t o b e i n d e p e n d e n t . D e p e n d e n t L e a r n i n g A c t i v i t i e s A s T a b l e 4 a l s o i n d i c a t e s , t h e r e s p o n d e n t s h a d p a r t i c i p a t e d i n a s m a n y a s n i n e a n d a s f e w a s z e r o d e p e n d e n t l e a r n i n g a c t i v i t i e s . O n t h e a v e r -a g e , t h e y r e c o r d e d a c t i v i t y i n 4 . 4 o f t h e i t e m s , w h i l e t w o - t h i r d s o f t h e m h a d p a r t i c i p a t e d i n t h r e e t o s i x o f t h e a c t i v i t e s . D i f f e r e n c e s B e t w e e n P a r t i c i p a t i o n i n I n d e p e n d e n t a n d  D e p e n d e n t A c t i v i t i e s A c o m p a r i s o n o f t h e s c o r e s o n t h e t w o s u b - i n d e x e s r e v e a l s t h e d i f -f e r e n c e s b e t w e e n n u r s e s ' p a r t i c i p a t i o n i n i n d e p e n d e n t a n d d e p e n d e n t l e a r n i n g a c t i v i t i e s . W h i l e t h e m a x i m u m n u m b e r ( 9 ) o f a c t i v i t i e s e n g a g e d i n b y t h e r e s p o n d e n t s w a s e q u a l o n b o t h s u b - i n d e x e s , t h e l o w e s t i n d e x s c o r e s d i f f e r e d . E a c h o f t h e r e s p o n d e n t s i n d i c a t e d t h a t t h e y h a d p a r t i c i p a t e d i n a t l e a s t o n e o f t h e i n d e p e n d e n t a c t i v i t i e s , w h e r e a s t h e l o w e s t d e p e n d e n t s c o r e w a s z e r o . A c o m p a r i s o n o f t h e t w o m e a n s s h o w e d t h a t t h e r e s p o n d e n t s p a r t i c i p a t e d i n o n e m o r e i n d e p e n d e n t a c t i v i t y - t h a n d e p e n d e n t . A t - t e s t c a l c u l a t e d o n t h e d i f f e r -e n c e b e t w e e n t h e m e a n s c o r e o n t h e i n d e p e n d e n t s u b - i n d e x a n d t h e m e a n s c o r e o n t h e d e p e n d e n t s u b - i n d e x p r o d u c e d a v a l u e o f 9 . 4 w h i c h w a s s i g n i f i c a n t b e y o n d t h e . 0 0 0 1 l e v e l . H e n c e , t h e n u l l h y p o t h e s i s w a s r e j e c t e d a n d t h e f i r s t 5 3 r e s e a r c h h y p o t h e s i s w a s a f f i r m e d ; t h a t i s , r e g i s t e r e d n u r s e s d i d p a r t i c -i p a t e m o r e i n i n d e p e n d e n t t h a n i n d e p e n d e n t l e a r n i n g a c t i v i t i e s . D e s c r i p t i o n o f P a r t i c i p a t i o n i n E a c h L e a r n i n g A c t i v i t y I n o r d e r t o e x a m i n e t h e r a t e o f p a r t i c i p a t i o n i n e a c h o f t h e l e a r n -i n g a c t i v i t i e s , t h e p e r c e n t a g e d i s t r i b u t i o n s a r e p r e s e n t e d a c c o r d i n g t o t h e t y p e o f a c t i v i t y a n d i n r a n k o r d e r ( T a b l e 5 ) . O n t h e t o t a l i n d e x , t h e p a r t i c i p a t i o n r a t e s r a n g e d f r o m 9 9 . 1 p e r c e n t o n t h e i n d e p e n d e n t i t e m " R e a d ' q u i c k - r e f e r e n c e ' n u r s i n g l i t e r a t u r e . . . " t o 2 . 7 p e r c e n t o n t h e d e p e n d e n t i t e m " T o o k n u r s i n g ' r e f r e s h e r ' c o u r s e " . I t w a s n o t s u r p r i s i n g t h a t t h r e e o f t h e f o u r m o s t f r e q u e n t l y r e p o r t e d i n d e p e n d e n t a c t i v i t i e s e n t a i l e d r e a d i n g v a r i o u s r e f e r e n c e m a t e r i a l s a s n u r s e s , l i k e o t h e r h e a l t h p r o f e s s i o n a l s , r e a d p r o f e s s i o n a l l i t e r a t u r e a s a w a y o f k e e p i n g u p - t o - d a t e . W h i l e t h e i n d e x d o e s n o t m e a s u r e h o w e x t e n s i v e l y t h e r e s p o n d e n t s p a r t i c i p a t e d i n t h i s k i n d o f e d u c a t i o n a l a c t i v i t y , a t l e a s t a r e l a t i v e l y h i g h p e r c e n t a g e o f n u r s e s d o s o t o s o m e d e g r e e . O n l y 8 5 . 0 p e r c e n t o f t h e r e s p o n d e n t s p e r c e i v e d t h e m s e l v e s a s e n g a g i n g i n d i v i d u a l l y i n d a y - t o - d a y p r o b l e m s o l v i n g i n n u r s i n g c a r e s i t u a t i o n s . T h i s r a t e o f r e s p o n s e w a s l o w e r t h a n e x p e c t e d a n d m a y b e e x p l a i n e d b y t h e n u m b e r o f r e s p o n d e n t s n o t i n v o l v e d i n d i r e c t p a t i e n t c a r e ( a d m i n i s t r a t o r s , e d u c a t o r s ) o r b y t h e p o s s i b i l i t y t h a t s o m e r e s p o n d e n t s d o n o t p e r c e i v e t h e i r n u r s i n g c a r e r o l e a s a p r o b l e m s o l v i n g p r o c e s s a n d t h e r e f o r e n o t a l e a r n i n g s i t u a t i o n . P a t i e n t t e a c h i n g i s a n i m p o r t a n t p a r t o f t h e n u r s e ' s r o l e . E v e n t h o u g h t h i s a s p e c t c a n n o t b e s e p a r a t e d f r o m t h e r e s p o n s e s t o t h e i n d e x i t e m r e l a t e d t o p r e p a r a t i o n f o r i n s t r u c t i n g p a t i e n t s a n d s t a f f , i t m a y b e n o t e d t h a t o v e r T a b l e 5 P e r c e n t a g e D i s t r i b u t i o n o f P a r t i c i p a t i o n i n C o n t i n u i n g L e a r n i n g A c t i v i t i e s a L e a r n i n g A c t i v i t y N u m b e r P e r c e n t a g e I n d e p e n d e n t : R e a d " q u i c k r e f e r e n c e " n u r s i n g l i t e r a t u r e s u c h a s p o l i c y a n d p r o c e d u r e m a n u a l s , d r u g m a n u a l s , p r o f e s s i o n a l p a m p h l e t s , a n d b r o c h u r e s . 2 1 8 9 9 . 0 9 R e a d p r o f e s s i o n a l n u r s i n g j o u r n a l s a n d t e x t b o o k s . 2 1 3 9 6 . 8 2 E n g a g e d i n d i v i d u a l l y i n d a y - t o - d a y p r o b l e m s o l v i n g i n n u r s i n g c a r e s i t u a t i o n ( s ) . 1 8 7 8 5 . 0 0 R e a d o t h e r ( n o n - n u r s i n g ) p r o f e s s i o n a l j o u r n a l s a n d t e x t b o o k s . 1 6 5 7 5 . 0 0 P r e p a r e d f o r i n s t r u c t i n g p a t i e n t s a n d o t h e r h o s p i t a l s t a f f . 1 5 7 7 1 . 3 6 D i d a s e l f - i n i t i a t e d a n d s e l f - d i r e c t e d s t u d y p r o j e c t o n a p a r t i c u l a r t o p i c . 8 6 3 9 . 0 9 D i d a f o r m a l s e l f - e v a l u a t i o n o f n u r s i n g p e r f o r m a n c e i n o r d e r t o i d e n t i f y s t r e n g t h s a n d a r e a s f o r f u r t h e r d e v e l o p m e n t . 7 8 3 4 . 4 5 U s e d a u d i o - v i s u a l m a t e r i a l s s u c h a s v i d e o -t a p e s , a u d i o - t a p e s , l o o p f i l m s , a n d s l i d e t a p e p r e s e n t a t i o n s w h i c h h a v e n o t b e e n m a d e a v a i l a b l e a s p a r t o f a n i n s e r v i c e , o r i e n t a t i o n , o r c l a s s p r o g r a m . 4 8 2 1 . 8 2 . D i d p r o g r a m e d i n s t r u c t i o n p a c k a g e ( s ) . ( e g . A m e r i c a n J o u r n a l o f N u r s i n g i t e m s o n h o s t i l i t y a n d a n x i e t y . ) 2 5 1 1 . 3 6 I n i t i a t e d a n d d i r e c t e d p r o f e s s i o n a l r e s e a r c h a n d s t u d y p r o j e c t ( s ) . 1 9 8 . 6 4 D i d i n d i v i d u a l s t u d y p a c k e t ( s ) . ( e g . " E m o t i o n a l N e e d s o f t h e h o s p i t a l i z e d p r e s c h o o l c h i l d " b y J . K o t a s k a . ) 1 2 5 . 4 5 T a b l e 5 ( c o n t i n u e d ) L e a r n i n g A c t i v i t y N u m b e r P e r c e n t a g e D e p e n d e n t ; A t t e n d e d w a r d / u n i t i n s e r v i c e p r o g r a m ( s ) . 1 9 9 9 0 . 4 5 A t t e n d e d h o s p i t a l - w i d e i n s e r v i c e p r o g r a m ( s ) . 1 9 0 8 6 . 3 6 A t t e n d e d w a r d / u n i t o r i e n t a t i o n p r o g r a m ( s ) . 1 5 2 6 9 . 0 9 P a r t i c i p a t e d i n a d i s c u s s i o n o f y o u r p e r s o n a l p e r f o r m a n c e e v a l u a t i o n . 1 4 0 6 3 . 6 4 A t t e n d e d h o s p i t a l - w i d e o r i e n t a t i o n p r o g r a m ( s ) . 1 1 4 5 1 . 8 2 A t t e n d e d n o n - c r e d i t s h o r t c o u r s e ( s ) , w o r k s h o p ( s ) , a n d c o n f e r e n c e ( s ) s p o n s o r e d b y t h e D i v i s i o n o f C o n t i n u i n g N u r s i n g E d u c a t i o n , S c h o o l o f N u r s i n g , U . B . C . 5 8 2 6 . 3 6 A s s i s t e d w i t h p r o f e s s i o n a l r e s e a r c h o r s t u d y p r o j e c t ( s ) . 5 3 2 4 . 0 9 A t t e n d e d n o n - c r e d i t s h o r t c o u r s e ( s ) , w o r k s h o p ( s ) a n d c o n f e r e n c e ( s ) s p o n s o r e d i n t e r p r o f e s s i o n a l l y b y t h e D i v i s i o n o f C o n t i n u i n g E d u c a t i o n i n t h e H e a l t h S c i e n c e s , U . B . C . 3 7 1 6 . 8 2 A t t e n d e d c e r t i f i c a t e c l i n i c a l c o u r s e ( s ) . ( e g . O . R . p r o g r a m a t S t . P a u l ' s H o s p i t a l ; P h a s e I I - I n t e n s i v e a n d C o r o n a r y C a r e C o u r s e s p o n s o r e d b y t h e D i v i s i o n o f C o n -t i n u i n g N u r s i n g E d u c a t i o n , S c h o o l o f N u r s i n g , U . B . C . ) 1 7 7 . 7 3 P a r t i c i p a t e d i n c r e d i t c o u r s e ( s ) o f f e r e d b y t h e S c h o o l o f N u r s i n g , U . B . C . 8 3 . 6 4 T o o k n u r s i n g " r e f r e s h e r " c o u r s e . 6 2 . 7 3 a . D u r i n g t h e p e r i o d S e p t e m b e r 1 , 1 9 7 2 - S e p t e m b e r 3 0 , 1 9 7 3 . 56 seventy percent (71.4%) of the respondents recorded participation in this a c t i v i t y . The extent of participation in sel f - i n i t i a t e d and self-directed study projects did not reach the anticipated proportions suggested by the experiences of Tough and Houle. This may be attributed to the respondents' limited interpretation of the item. An open-ended interview situation might have e l i c i t e d a higher response rate than the more restrictive questionnaire format used in this investigation. Even so, almost forty percent of the respondents (39.1%) did acknowledge engaging in this particular mode of i n -dependent learning. Other forms of self-study involving various individualized resources such as audio-visual and programed materials received a markedly lower response rate. These learning resources are relatively recent innovations in education-a l technology and therefore are unfamiliar to many adult learners. For those accustomed to learning in the more traditional environment characterized by lecture presentations and other group-oriented techniques, there i s s t i l l some reluctance to accept and u t i l i z e the new educational modalities. The lack of sufficient and appropriate individualized learning resources, in nursing and the other health disciplines creates yet another deterrent to participation in independent learning a c t i v i t i e s . It would be important to know whether the nurses sampled in this study were not aware that these learning opportuni-ties existed, whether they preferred to participate in other types of learning a c t i v i t i e s , or did not have access to such resources. Among the different dependent learning a c t i v i t i e s , the respondents participated most actively in inservice and orientation programmes provided by their employing agencies. The rate of response was higher in the inservice 5 7 . i t e m s t h a n t h e o r i e n t a t i o n o n e s s i n c e o n l y n e w e m p l o y e e s a r e i n v o l v e d i n t h e o r i e n t a t i o n p r o g r a m s . N e v e r t h e l e s s , t h e e x t e n t o f p a r t i c i p a t i o n i n h o s p i t a l - w i d e a n d u n i t o r i e n t a t i o n w a s h i g h . T h i s i s u n d o u b t e d l y a n o u t -c o m e o f a h i g h a n n u a l t u r n o v e r r a t e o f n u r s i n g p e r s o n n e l i n h o s p i t a l s . W h i l e m o r e t h a n 6 0 p e r c e n t o f t h e r e s p o n d e n t s ( 6 3 . 6 % ) i n d i c a t e d t h a t t h e y h a d r e c e i v e d a n d d i s c u s s e d a n e v a l u a t i o n o f t h e i r p e r f o r m a n c e d u r i n g t h e y e a r s u r v e y e d , i t w a s e v i d e n t t h a t t h e h o s p i t a l s i n v o l v e d h a v e y e t t o a c h i e v e t h e d e s i r a b l e p r o f e s s i o n a l s t a n d a r d t h a t e v e r y n u r s i n g s t a f f m e m b e r r e c e i v e a n a n n u a l a s s e s s m e n t o f h e r p e r f o r m a n c e . I n a d d i t i o n o n l y 3 5 . 5 p e r c e n t o f t h e r e s p o n d e n t s h a d p a r t i c i p a t e d i n t h e i r e v a l u a t i o n b y d o i n g a s t r u c t u r e d s e l f - a s s e s s m e n t . S e l f - e v a l u a t i o n i s n o t a n e w c o n c e p t i n n u r s i n g b u t a s y e t i t h a s n o t b e e n g e n e r a l l y a c c e p t e d a n d i m p l e m e n t e d . A p p r o x i m a t e l y o n e - h a l f o f t h e r e s p o n d e n t s a t t e n d e d n o n - c r e d i t c o n -t i n u i n g e d u c a t i o n o f f e r i n g s s p o n s o r e d b y t h e D i v i s i o n o f C o n t i n u i n g E d u c a t i o n i n t h e H e a l t h S c i e n c e s . T w e n t y - s i x p e r c e n t o f t h e r e s p o n d e n t s w e r e i n v o l v e d i n p r o g r a m s p r o v i d e d b y t h e D i v i s i o n o f C o n t i n u i n g N u r s i n g E d u c a t i o n , S c h o o l o f N u r s i n g a s c o m p a r e d w i t h 1 6 . 8 p e r c e n t w h o p a r t i c i p a t e d i n i n t e r p r o f e s s i o n a l e v e n t s . I n a s m u c h a s t h e r e s p o n s e s t o t h e s e t w o i t e m s o n l y r e f l e c t t h e p a r t i -c i p a t i o n o f n u r s e s i n n o n - c r e d i t a c t i v i t i e s s p o n s o r e d b y o n e i n s i t u t i o n , i t m a y b e a s s u m e d t h a t t h e e x t e n t o f t o t a l p a r t i c i p a t i o n i n n o n - c r e d i t p r o g r a m s w a s a c t u a l l y g r e a t e r . O n e - t h i r d o f t h e r e s p o n d e n t s h a d b e e n i n v o l v e d i n s o m e f o r m o f p r o -f e s s i o n a l r e s e a r c h o r s t u d y p r o j e c t . T h i s s t a t i s t i c m a y b e s o m e w h a t i n f l a t e d o w i n g t o t h e p o s s i b i l i t y t h a t s o m e o f t h e r e s p o n d e n t s m a y h a v e b o t h i n i t i a t e d a n d a s s i s t e d w i t h s u c h p r o j e c t s o v e r t h e p a s t y e a r . O n t h e s a m e b a s i s i t m a y b e e x a g g e r a t i n g t o r e p o r t t h a t r o u g h l y t e n p e r c e n t ( 7 . 7 3 % p l u s 3 . 6 4 % ) o f t h e 58 respondents had participated in credit courses during that twelve month period. However, i t appears that a number of nurses were interested in taking courses for credit. Finally, six of the respondents had taken 'refresher' courses in 1972-73. Such programs are f a i r l y recent additions to the educational offerings available to nurses in British Columbia and so, this rate of response was understandably low. ORIENTATIONS TO CONTINUOUS LEARNING Eight factors were extracted from the Learning Orientation Index data by principal components analysis with varimax rotation. Only seven of these were interpreted as meaningful orientations. Table 6 ill u s t r a t e s the various sets of items which clustered into each of the factors and the variance i n the data accounted for before and after rotation by each cluster. The three seemingly unrelated items in factor VIII could not be identified as a learning orientation. The f i r s t seven factors accounted for 48.2 per-cent of the variance among a l l items after rotation. Tables 7 and 8 have been included here to f a c i l i t a t e a comparison of the present study's results with those of Sheffield and Sovie (36, 37). The complete factor structure after rotation i s presented in Appendix D . This includes the factor loadings of each item on each factor. Since Sheffield and Sovie both included a l l items with factor loadings of .40 or greater as contributing to the meaning of the factors, this study does l i k e -wise for the purposes of comparison. Appendix E outlines the distribution Table 6 Learning O r i e n t a t i o n F a c t o r s and Percentage of Variance i n the Data Accounted f o r Fa c t o r Number and Name Item Numbers Percentage Data of V a r iance i n the Accounted f o r Before R o t a t i o n A f t e r R o t a t i o n I LEARNING ORIENTATION 5 , 7 , 8 , 1 1 , 1 4 , 1 6 , 2 0 , 2 4 b , 2 6 , 2 8 , 3 0 , 3 1 , 3 5 , 3 7 , 4 3 , 4 6 , 4 8 , 5 2 , 5 4 , 5 8 2 4 . 8 1 6 . 8 I I SOCIABILITY ORIENTATION 2 , 1 2 , 2 2 , 2 5 , 3 2 , 3 3 b , 4 2 , 4 9 , 5 1 , 5 3 , 5 6 1 1 . 1 9 . 8 I I I OCCUPATIONAL ORIENTATION 1 , 1 5 , 1 8 , 2 3 , 2 9 , 4 2 , 4 9 , 5 0 , 5 5 4 . 2 6 . 4 IV PROFESSIONAL ORIENTATION 7 , 3 4 , 3 8 , 4 4 , 5 7 3 . 2 4 . 3 V SOCIETAL ORIENTATION 3 1 , 4 0 , 4 1 , 4 2 , 4 7 b - 2 . 5 3 . 5 VI INTERACTIVE ORIENTATION 9 , 1 0 , 1 7 , 3 9 2 . 3 3 . 8 V I I RELIEF FROM BOREDOM AND FRUSTRATION ORIENTATION 1 9 , 3 6 , 4 5 1 . 9 3 . 6 V I I I c Not named. 3 , 4 , 2 1 1 . 9 3 . 6 TOTAL VARIANCE ACCOUNTED FOR 5 1 . 8 % 5 1 . 8 % a. Items number 6 , 1 3 , and 27 were not s u f f i c i e n t l y r e l a t e d to any of the e i g h t f a c t o r s and a r e , t h e r e f o r e , not in c l u d e d i n the t a b l e . b. These items loaded on the f a c t o r s to a l e s s e r extent than the predetermined . 4 0 l e v e l , but are i n c l u d e d i n the t a b l e s i n c e they c o n t r i b u t e d to the i d e n t i f i c a t i o n of o r i e n t a t i o n s . c. Items i n c l u d e d i n Factor V I I I could not be i n t e r p r e t e d m e a n i n g f u l l y as a separate o r i e n t a t i o n . Table 7 S h e f f i e l d ' s Learning O r i e n t a t i o n Factors and Percentage of Variance i n the Data Accounted f o r ( 3 6 ) Factor Number and Name Item Numbers Percentage of Variance i n the Data Accounted f o r . I LEARNING ORIENTATION 4 , 5 , 7 , 1 1 , 1 4 , 1 6 , 2 0 , 2 4 , 2 6 , 2 8 , 3 0 , 3 5 , 3 7 , 4 3 , 4 4 , 4 6 , 5 2 , 5 4 , 5 8 2 6 I I SOCIABILITY ORIENTATION 2 , 1 0 , 1 2 , 1 7 , 2 2 , 2 5 , 2 7 , 3 2 , 5 1 , 5 3 , 5 6 1 1 I I I PERSONAL-GOAL ORIENTATION 1 , 1 5 , 1 8 , 2 3 , 2 9 , 3 4 , 3 8 , 5 5 , 5 7 8 IV SOCIETAL-GOAL ORIENTATION 6 , 2 1 , 3 1 , 3 9 , 4 1 , 4 7 5 V NEED-FULFILLMENT ORIENTATION 1 3 , 1 9 , 3 6 , 4 2 , 4 9 3 VI Not named. 4 8 , 5 0 3 V I I Not named. 3 3 2 . 5 TOTAL VARIANCE ACCOUNTED FOR 5 8 . 5 % o T a b l e 8 S o v i e ' s L e a r n i n g O r i e n t a t i o n F a c t o r s a n d P e r c e n t a g e o f V a r i a n c e i n t h e D a t a A c c o u n t e d f o r ( 3 7 ) F a c t o r N u m b e r a n d N a m e I t e m N u m b e r s P e r c e n t a g e o f V a r i a n c e i n t h e D a t a A c c o u n t e d f o r . I L E A R N I N G O R I E N T A T I O N 4 , 5 , 6 , 7 , 8 , 9 , 1 1 , 1 4 , 1 6 , 2 0 , 2 4 , 2 6 , 2 8 , 3 0 , 3 5 , 3 7 , 4 3 , 4 4 , 4 6 , 5 2 , 5 4 , 5 8 3 5 . 0 I I P E R S O N A L - S O C I A B I L I T Y O R I E N T A T I O N . 2 , 3 , 1 0 , 1 2 , 1 3 , 1 8 , 1 9 , 2 2 , 2 5 , 2 7 , 3 2 , 3 3 , 4 0 , 4 2 , 4 5 , 4 9 , 5 1 , 5 3 , 5 6 1 1 . 4 I l l P R O F E S S I O N A L - G O A L O R I E N T A T I O N 2 3 , 2 9 , 4 8 , 5 0 , 5 2 , 5 5 4 . 4 I V S O C I E T A L - G O A L O R I E N T A T I O N 6 , 2 1 , 3 1 , 4 1 , 4 7 3 . 9 V O C C U P A T I O N A L - G O A L O R I E N T A T I O N 3 4 , 3 8 , 5 7 2 . 7 V I N E E D - F U L F I L L M E N T O R I E N T A T I O N 1 3 , 1 9 , 3 5 , 3 6 , 4 0 , 4 2 2 . 6 V I I P E R S O N A L - G O A L O R I E N T A T I O N 6 , 9 , 1 5 2 . 2 V I I I P R O F E S S I O N A L - S O C I A B I L I T Y O R I E N T A T I O N 2 2 , 2 3 , 2 5 2 . 0 I X N o t n a m e d . 8 , 3 8 , 3 9 1 . 9 X N o t n a m e d . 1 7 1 . 8 X I N o t n a m e d . 1 , 4 8 1 . 8 T O T A L V A R I A N C E A C C O U N T E D F O R 6 9 . 7 % of scores on each of the 5 8 Learning O r i e n t a t i o n Index statements for the purposes of comparing the responses to the i n d i v i d u a l i tems. The seven meaningful l e a r n i n g o r i e n t a t i o n s that r e s u l t e d from the i n t e r p r e t a t i o n of the r e s u l t s of the fac tor a n a l y s i s procedure used i n t h i s study inc lude ( 1 ) Learning O r i e n t a t i o n , ( 2 ) S o c i a b i l i t y O r i e n t a t i o n , ( 3 ) Occupat ional O r i e n t a t i o n , ( 4 ) P r o f e s s i o n a l O r i e n t a t i o n , ( 5 ) S o c i e t a l O r i e n t a t i o n , ( 6 ) I n t e r a c t i v e O r i e n t a t i o n , and ( 7 ) R e l i e f from Boredom and F r u s t r a t i o n O r i e n t a t i o n . Each of these i s descr ibed below i n terms of the items comprising the d i f f e r e n t f a c t o r s . The items are l i s t e d i n descending order according to the f a c t o r l o a d i n g s . These values precede each item whi le the o r i g i n a l item number i s noted i n parentheses fo l lowing the item statements. Learning O r i e n t a t i o n Factor I emerged as a c l u s t e r of twenty items and accounted for 1 6 . 8 percent of the t o t a l var iance a f t e r r o t a t i o n . . 8 1 To enjoy seeking knowledge. ( 5 4 ) . 7 8 To s a t i s f y i n t e l l e c t u a l c u r i o s i t y . ( 2 8 ) . 7 7 To f i l l an innate yearning for knowledge. ( 1 6 ) . 7 4 To f i n d i n t e l l e c t u a l enrichment and mental s t i m u l a t i o n . ( 3 7 ) . 7 3 To enjoy a c q u i r i n g more knowledge. ( 5 8 ) . 7 3 To des i re to l e a r n and to know. ( 4 6 ) . 7 2 To s a t i s f y an i n q u i r i n g mind. ( 3 0 ) . 7 1 To pursue a path of i n t e l l e c t u a l c u r i o u s i t y . ( 8 ) . 7 1 To fur ther expose an i n s a t i a b l y cur ious mind. ( 2 0 ) . 6 6 To enjoy the s a t i s f a c t i o n that comes from l e a r n i n g . ( 1 1 ) . 6 3 To d e s i r e enlightenment. ( 2 6 ) . 6 2 To f e e l a need for more educat ion . ( 5 2 ) 6 3 • . 6 1 To satisfy a deep curiosity about l i f e and ideas. ( 4 3 ) . 5 9 To study for i t s own sake. ( 3 5 ) . 5 7 To satisfy an innate need for information and knowledge. ( 5 ) . 4 7 To introduce me to new ideas which I can further explore on my own. ( 1 4 ) . 4 3 To participate in education as an end in i t s e l f . ( 4 8 ) . 4 3 To become a more effective citizen. ( 3 1 ) . 4 2 To seek helpful insights about human relationships. ( 7 ) •36 To get the satisfaction of accomplishment. ( 2 4 ) With the exception of items 3 1 and 7 , each of the above relate to the enjoy-ment of acquiring new knowledge and the interest in learning for i t s own sake rather than for some specific purpose. Hence the factor was identified as Learning Orientation. Items 3 1 and 7 were not consistent with the common theme and were the two items which also loaded to a significant and more mean-ingful extent on a second factor (factor V and IV respectively). Item 24 is consistent with the notion of learning for learning sake and therefore is included even though i t did not load on the factor at the . 4 0 l e v e l . Sociability Orientation Factor II included a consistent grouping of eleven items and accounted for 9 . 8 percent of the total variance after rotation. - . 7 7 To experience the pleasure of meeting new people. ( 2 5 ) - . 7 5 To enjoy the association with other people. ( 5 6 ) - . 7 5 To f u l f i l l a need for personal associations and friendships. ( 1 2 ) - . 7 1 To become acquainted with congenial people. ( 3 2 ) - . 7 1 To make new friends. ( 2 2 ) - . 6 5 To be with friends and. associates. ( 2 ) - . 6 2 To undertake an activity with a friend. ( 5 1 ) - . 5 9 To enjoy socially oriented learning a c t i v i t i e s . ( 5 3 ) 64 - . 4 4 T o f e e l a s o c i a l n e e d t o b e a p a r t o f a n a c c e p t e d g r o u p . ( 4 2 ) - . 4 3 T o f e e l a n e e d t o b e a c c e p t e d b y o t h e r s . ( 4 9 ) - . 3 9 T o e n j o y t h e p l e a s u r e o f d i s c o u r s e . ( 3 3 ) E v e n t h o u g h i t e m s 42 a n d 4 9 l o a d e d o n o t h e r f a c t o r s a s w e l l , t h e y c o n t r i -b u t e d m e a n i n g f u l l y t o t h e i n t e r p r e t a t i o n o f t h i s o r i e n t a t i o n . O n c e a g a i n , i t e m 3 3 w h i c h o n l y l o a d e d a t - . 3 9 o n t h e f a c t o r w a s i n c l u d e d b e c a u s e o f i t s c o n s i s t e n c y w i t h t h e i d e n t i f i e d m e a n i n g o f t h e c l u s t e r . T h e s e c o n d f a c t o r w a s n a m e d S o c i a b i l i t y O r i e n t a t i o n i n a s m u c h a s a l l e l e v e n i t e m s p e r -t a i n e d t o s o c i a l r e a s o n s w h y n u r s e s e n g a g e i n e d u c a t i o n a l a c t i v i t i e s . O c c u p a t i o n a l O r i e n t a t i o n T h e t h i r d f a c t o r c o n t a i n e d n i n e i t e m s a n d a c c o u n t e d f o r 6 . 4 p e r c e n t o f t h e t o t a l v a r i a n c e a f t e r r o t a t i o n . . 6 5 T o s e c u r e p r o f e s s i o n a l a d v a n c e m e n t . ( 2 3 ) . 6 2 T o u s e e d u c a t i o n a s a m e a n s t o h i g h e r s t a t u s a n d p r e s t i g e . ( 5 5 ) . 6 2 T o g a i n r e c o g n i t i o n a m o n g p e e r s . ( 1 8 ) . 6 0 T o u n d e r t a k e e d u c a t i o n a s a m e a n s t o a n e n d . ( 5 0 ) . 5 9 T o f i l l a n e c o n o m i c m o t i v a t i o n . ( 1 5 ) . 5 0 T o f e e l a n e e d t o b e a c c e p t e d b y o t h e r s . ( 4 9 ) . 4 6 T o c l a r i f y w h a t I w i s h t o b e d o i n g 5 o r 1 0 y e a r s f r o m n o w . ( 2 9 ) . 4 4 T o r e t r a i n f o r v o c a t i o n a l c h a n g e s . ( 1 ) . 4 0 T o f e e l a s o c i a l n e e d t o b e p a r t o f a n a c c e p t e d g r o u p . ( 4 2 ) D e s p i t e t h e r e f e r e n c e t o a m o r e s p e c i f i c ' p r o f e s s i o n a l ' c o m p o n e n t i n i t e m 2 3 , m o s t o f t h e i t e m s i n t h i s c l u s t e r r e l a t e d t o g e n e r a l o c c u p a t i o n a l c o n -c e r n s s u c h a s a d v a n c e m e n t , s t a t u s a n d p r e s t i g e , r e c o g n i t i o n , i n c o m e , f u t u r e c a r e e r g o a l s , a n d r e t r a i n i n g . F o r t h i s r e a s o n , F a c t o r I I I w a s c a l l e d O c c u p a t i o n a l O r i e n t a t i o n . 65 P r o f e s s i o n a l O r i e n t a t i o n F a c t o r I V w a s c o m p r i s e d o f a c l u s t e r o f f i v e i t e m s a n d a c c o u n t e d f o r 4 . 3 p e r c e n t o f t h e v a r i a n c e i n t h e d a t a . - . 6 1 T o i n c r e a s e c o m p e t e n c e i n e m p l o y m e n t . ( 3 4 ) - . 6 0 T o u p - g r a d e o c c u p a t i o n a l c o m p e t e n c y . ( 5 7 ) - . 5 6 T o d e v e l o p u n d e r s t a n d i n g . ( 4 4 ) - . 4 3 T o l e a r n b e t t e r w a y s t o d o t h i n g s . ( 3 8 ) - . 4 1 T o s e e k h e l p f u l i n s i g h t s a b o u t h u m a n r e l a t i o n s h i p s . ( 7 ) I t i s s i g n i f i c a n t t h a t t h i s f a c t o r e m e r g e d a s a d i s c r e t e l e a r n i n g o r i e n t a -t i o n f o r t h i s p a r t i c u l a r g r o u p o f a d u l t l e a r n e r s . C u r r e n t l y , t h e p r i m e p r o f e s s i o n a l c o n c e r n i n n u r s i n g r e l a t e s t o t h e m a i n t e n a n c e o f c o m p e t e n c e a s a m e a n s o f e n s u r i n g t h e q u a l i t y o f p a t i e n t c a r e . I n a s o m e w h a t m o r e i n d i r e c t w a y i t e m s 4 4 a n d 7 a r e c o n s i s t e n t w i t h t h e c o m p e t e n c y t h e m e i n t h a t " d e v e l o p i n g u n d e r s t a n d i n g " i s a n i n t e g r a l p a r t o f p e r f o r m a n c e e n h a n c e m e n t a n d " s e e k i n g h e l p f u l i n s i g h t s a b o u t h u m a n r e l a t i o n s h i p s " i s a n e c e s s a r y c o m -p o n e n t o f c o m p e t e n t n u r s i n g p r a c t i c e . O n t h e b a s i s o f t h i s r a t i o n a l e , t h e g r o u p o f i t e m s w a s n a m e d P r o f e s s i o n a l O r i e n t a t i o n . S o c i e t a l O r i e n t a t i o n F a c t o r s V c o n t a i n e d f i v e i t e m s a n d a c c o u n t e d f o r 3 . 5 p e r c e n t o f t h e t o t a l v a r i a n c e a f t e r r o t a t i o n . - . 6 6 T o s e e k t o c o n t r i b u t e t o t h e c o m m o n g o o d . ( 4 1 ) - . 5 5 T o b e l i e v e t h a t t h e a c t i v i t y p r o v i d e s r e s p e c t i b i l i t y . ( 4 0 ) - . 4 7 T o f e e l a s o c i a l n e e d t o b e a p a r t o f a n a c c e p t e d g r o u p . ( 4 2 ) - . 4 6 T o b e c o m e a m o r e e f f e c t i v e c i t i z e n . ( 3 1 ) - . 3 8 T o p r e p a r e f o r s e r v i c e i n t h e c o m m u n i t y . ( 4 7 ) 6 6 E v e n t h o u g h i t e m 47 o n l y l o a d e d o n t h e f a c t o r a t - . 3 8 , l e s s t h a n t h e p r e -d e t e r m i n e d l e v e l o f . 4 0 , i t w a s i n c l u d e d i n t h e l i s t b e c a u s e o f i t s c o n t r i -b u t i o n t o t h e m e a n i n g o f t h e c l u s t e r . W h i l e t h e i t e m s a r e n o t a s c o n s i s t e n t a s i n p r e v i o u s f a c t o r s m o s t o f t h e m i n d i c a t e s o c i e t a l o r c o m m u n i t y c e n t e r e d r e a s o n s w h y l e a r n e r s p a r t i c i p a t e i n e d u c a t i o n a l a c t i v i t i e s . H e n c e , t h e f i f t h f a c t o r w a s l a b e l l e d S o c i e t a l O r i e n t a t i o n . I n t e r a c t i v e O r i e n t a t i o n F o u r i t e m s l o a d e d p r e d o m i n e n t l y o n F a c t o r V I a n d s h a r e d 3 . 8 p e r c e n t o f t h e v a r i a n c e i n t h e d a t a . . 6 9 T o e x c h a n g e i d e a s a n d i n f o r m a t i o n . ( 9 ) . 6 7 T o e n g a g e i n t h e d i s c u s s i o n o f i d e a s . ( 3 9 ) . 4 7 T o a s s o c i a t e w i t h o t h e r s o f s i m i l a r i n t e r e s t s . ( 1 0 ) . 4 3 T o u n d e r t a k e g r o u p p a r t i c i p a t i o n s a s a s o c i a l l y a c c e p t a b l e c h a n g e f r o m i s o l a t e d i n d i v i d u a l s t u d y . ( 1 7 ) T h e s e i t e m s a r e s o m e w h a t a k i n t o t h o s e c l u s t e r i n g i n t h e s e c o n d f a c t o r i n t h a t t h e y r e l a t e t o s o c i a l l y o r i e n t e d r e a s o n s w h y l e a r n e r s p a r t i c i p a t e i n e d u c a t i o n a l a c t i v i t i e s . Y e t t h e y d i f f e r i n t h a t t h e y a l s o r e f l e c t a d u l t s ' n e e d s f o r i n t e l l e c t u a l s t i m u l a t i o n a s w e l l a s d e s i r e s t o a f f i l i a t e w i t h o t h e r l e a r n e r s . W h i l e i t e m 17 s u g g e s t s t h a t t h i s f a c t o r m a y r e p r e s e n t a g r o u p l e a r n i n g o r i e n t a t i o n , t h e o t h e r m o r e d o m i n a n t i t e m s c a n b e i n t e r p r e t e d m o r e b r o a d l y t o m e a n t h a t n u r s e s w a n t t o e n g a g e i n l e a r n i n g i n o r d e r t o h a v e a n o p p o r t u n i t y t o e x c h a n g e i d e a s a n d c o m m o n i n t e r e s t s w i t h o t h e r l e a r n e r s . T h i s n e e d n o t b e l i m i t e d t o a g r o u p l e a r n i n g s i t u a t i o n b u t c a n a l s o o c c u r i n a n i n f o r m a l s e n s e b e t w e e n o n e o r t w o o t h e r i n t e r e s t e d l e a r n e r s . T h e r e f o r e , F a c t o r V I w a s c a l l e d I n t e r a c t i v e O r i e n t a t i o n . 6 7 R e l i e f from Boredom and F r u s t r a t i o n O r i e n t a t i o n Only three items loaded on Factor VII to any s i g n i f i c a n t extent and together they accounted for 3.6 percent of the t o t a l var iance a f t e r r o t a t i o n . - .67 To seek r e l i e f from boredom. (19) - .55 To overcome the f r u s t r a t i o n of day-to-day l i v i n g . (36) - .44 To use l e a r n i n g s i t u a t i o n s for s o c i a l purposes.(45) Once aga in , t h i s fac tor appears to be assoc ia ted wi th s o c i a l or a f f i l l a t i v e reasons why l e a r n e r s partake of educat iona l events and t h i s i s c l e a r l y r e -f l e c t e d i n item 45. At the same t ime, items 19 and 36 a l l u d e to a more prec i s e i n t e r p r e t a t i o n that incorporates l e a r n e r s ' needs for escape or r e l i e f from boredom and the f r u s t r a t i o n s of day-to-day l i v i n g . Hence, the f a c t o r was named R e l i e f from Boredom and F r u s t r a t i o n O r i e n t a t i o n . D i s c u s s i o n On the bas i s of these e m p i r i c a l r e s u l t s , i t would appear that r e g i s -tered nurses do possess v a r y i n g o r i e n t a t i o n s to l e a r n i n g . Seven s p e c i f i c o r i e n t a t i o n s were i d e n t i f i e d and named: (1) l e a r n i n g , (2) s o c i a b i l i t y , (3) o c c u p a t i o n a l , (4) p r o f e s s i o n a l , (5) s o c i e t a l , (6) i n t e r a c t i v e and (7) r e l i e f from boredom and f r u s t r a t i o n . Together, they accounted for 48.2 percent of the t o t a l var iance among a l l 58 items i n the index. While more l e a r n i n g o r i e n t a t i o n s emerged than the three o r i g i n a l l y hypothes ized , the a d d i t i o n a l four o r i e n t a t i o n s were conceptual ly cons i s tent with Houle 's bas i c typology. The f i r s t c l u s t e r of twenty items which accounted for a s u b s t a n t i a l propor t ion of the t o t a l var iance (16.8%) was i n t e r p r e t e d to be p a r a l l e l to 68 Houle's " learning o r i e n t a t i o n " . The Occupat iona l , P r o f e s s i o n a l and S o c i e t a l Or i en ta t ions i d e n t i f i e d for t h i s p a r t i c u l a r group of adul t l earners accounted for 14.2 percent of the t o t a l var iance c o l l e c t i v e l y and provided more p r e c i s e d e f i n i t i o n s of what Houle descr ibed as "goa l -or iented" reasons for l e a r n i n g . Registered nurses charac ter i zed by these three o r i e n t a t i o n s to l e a r n i n g are s i m i l a r i n that they have a purpose or o b j e c t i v e i n mind to motivate t h e i r involvement i n educat ional a c t i v i t i e s . Neverthe less , they could be d i f f e r -ent ia ted i n terms of the focus of t h e i r g o a l - d i r e c t e d behaviour . Inasmuch as the S o c i a b i l i t y , I n t e r a c t i v e and R e l i e f from Boredom and F r u s t r a t i o n O r i e n t a -t i ons were a l l r e l a t e d to s o c i a l needs and i n t e r e s t s that prompt a d u l t s ' p a r t i c i p a t i o n i n educat ion i t was concluded that Houle 's " a c t i v i t y - o r i e n t e d l earners" were merely more sharply descr ibed wi th these nurses . Together, these l a s t three f a c t o r s accounted for 17.2 percent of the t o t a l v a r i a n c e . The second hypothesis that r e g i s t e r e d nurses possess three b a s i c l e a r n i n g o r i e n t a t i o n s which may be descr ibed as g o a l , a c t i v i t y and l e a r n i n g -or iented was therefore conf irmed. At the same time, Houle 's i n i t i a l typology was extended to provide c l e a r e r d i s t i n c t i o n s among nurses and t h e i r reasons for engaging i n educat iona l a c t i v i t i e s . These f ind ings are s i m i l a r to those reported by S h e f f i e l d and Sov ie . While the number of fac tors and the order i n which they emerged tended to v a r y , the meaning of the c l u s t e r s and the i n t e r p r e t a t i o n of the o r i e n t a t i o n s are q u i t e c o n s i s t e n t . In a l l three i n v e s t i g a t i o n s the ' l e a r n i n g o r i e n t a t i o n ' was c l e a r l y i d e n t i f i e d as . the f i r s t and l a r g e s t c l u s t e r of fac tored i tems. Even though Sovie chose to modify the name of her second f a c t o r , the r e p e t i t i o n of items i n each study r e f l e c t s the p a r a l l e l nature of that ' a c t i v i t y - o r i e n t e d ' c l u s t e r . 6 9 W i t h t h e i d e n t i f i c a t i o n o f t h e t h i r d o r i e n t a t i o n , d i f f e r e n c e s b e g a n o c c u r r i n g i n t h e t h r e e f a c t o r s t r u c t u r e s . T h e s e v a r i a t i o n s a r e r e l a t i v e l y m i n o r , h o w e v e r , a n d d o n o t d e t r a c t f r o m t h e r e a f f i r m a t i o n o f t h e e x i s t e n c e o f b a s i c l e a r n i n g o r i e n t a t i o n s a n d t h e i r a p p l i c a b i l i t y t o v a r i o u s g r o u p s o f a d u l t l e a r n e r s . A T T I T U D E T O W A R D C O N T I N U I N G N U R S I N G E D U C A T I O N A m e a s u r e o f r e g i s t e r e d n u r s e s ' a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u -c a t i o n w a s o b t a i n e d f o r a l l 2 2 0 r e s p o n d e n t s o n t h e m o d i f i e d A d o l p h - W h a l e y s c a l e . T h e p o s s i b l e s c a l e s c o r e s r a n g e d f r o m f i v e t o n i n e t y , w i t h t h e h i g h e r s c o r e s r e f l e c t i n g a m o r e f a v o u r a b l e a t t i t u d e . T h e a c t u a l s c o r e s v a r i e d f r o m a m i n i m u m o f 4 4 t o a m a x i m u m o f 8 6 . T h e a v e r a g e s c o r e f o r t h e s a m p l e w a s 6 7 . 5 w i t h a s t a n d a r d d e v i a t i o n o f 1 0 . 6 . T h e s e r e s u l t s i n d i c a t e t h a t t h e m a j o r i t y o f r e g i s t e r e d n u r s e s ( 8 1 . 8 % ) h a d a m o d e r a t e l y t o h i g h l y f a v o u r a b l e a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n . T h i s c o n c l u s i o n w a s r e i n f o r c e d b y t h e f i n d i n g s o n t h e s e l f - r a t i n g s c a l e i n c l u d e d a s a n a d d i t i o n a l m e a s u r e o f t h e r e s p o n d e n t ' s a t t i t u d e w h i c h w a s u s e d a s a m e a n s o f p r e d i c t i n g t h e v a l i d i t y o f t h e a c t u a l e i g h t e e n i t e m s c a l e . T h e s c o r e s o b t a i n e d o n t h e t e n i n t e r v a l s e l f - r a t i n g s c a l e r a n g e d f r o m z e r o t o t e n w i t h a m e a n o f 7 . 7 a n d a s t a n d a r d d e v i a t i o n o f 1 . 6 . T h e c o e f f i c i e n t o f c o r r e l a t i o n b e t w e e n t h e s e l f - r a t i n g s c a l e s c o r e s a n d t h e a c t u a l s c o r e s w a s r = . 4 4 1 . T h i s v a l u e i s l o w e r t h a n t h a t o b t a i n e d b y A d o l p h a n d W h a l e y ( r = . 7 9 4 ) w h e n t h e y a d m i n i s t e r e d t h e s c a l e s t o a d u l t e d u c a t o r s ( 1 ) . I t w o u l d a p p e a r t h a t e i t h e r t h e r e s p o n d e n t s i n t h i s s t u d y 70 were not p a r t i c u l a r l y accurate i n assess ing t h e i r a t t i t u d e to cont inuing nurs ing education or that the Adolph-Whaley scale cannot be e f f e c t i v e l y adapted to s p e c i f i c and s p e c i a l i z e d areas of adul t education such as c o n -t i n u i n g nurs ing educat ion . RELATIONSHIPS BETWEEN PSYCHOLOGICAL AND SOCIO-ECONOMIC FACTORS AND EXTENT AND NATURE OF PARTICIPATION Fo l lowing the t a b u l a t i o n of the frequency d i s t r i b u t i o n s of responses on the four components of the ques t i onna ire , the data were analyzed to i n -v e s t i g a t e the r e l a t i o n s h i p s between the var ious independent and dependent v a r i a b l e s . The three dependent v a r i a b l e s inc lude the scores on the t o t a l p a r t i c i p a t i o n index and the independent and the dependent subindexes. The independent v a r i a b l e s inc lude a l l the p s y c h o l o g i c a l and socio-economic c h a r -a c t e r i s t i c s of the respondents: f a c t o r scores on the seven i d e n t i f i e d l e a r n i n g o r i e n t a t i o n s , scores on the a t t i t u d e to cont inuing nurs ing educat ion s c a l e , age, m a r i t a l s t a t u s , t o t a l number of c h i l d r e n , number of preschool c h i l d r e n , number of elementary school c h i l d r e n , number of secondary school c h i l d r e n , i n i t i a l educat ional p r e p a r a t i o n , u n i v e r s i t y educat iona l exper ience , years s ince graduat ion , years a c t i v e nurs ing p r a c t i c e , years not p r a c t i c i n g i n n u r s i n g , l ength of employment i n current employing h o s p i t a l , employment s tatus and p o s i t i o n . Table 9 shows values from the obtained c o r r e l a t i o n m a t r i x . Pearson's product moment c o e f f i c i e n t (r) was used with the i n t e r v a l - i n t e r v a l data whi le c o r r e l a t i o n r a t i o ' s (R) were obtained from the i n t e r v a l - n o m i n a l data ana lyses . Underl ined values were s i g n i f i c a n t at the .05 or .01 l e v e l . Table 9 7 1 C o r r e l a t i o n s Between P a r t i c i p a t i o n and Selected Independent V a r i a b l e s Independent V a r i a b l e s DEPENDENT VARIABLES T o t a l P a r t i c i p a t i o n P a r t i c i p a t i o n -Independent P a r t i c i p a t i o n -Dependent A t t i t u d e .36 - .02 .02 Or ien ta t ions 1. Learning .23 .00 - . 00 2. S o c i a b i l i t y .04 - .14 .13 3. Occupat ional .09 .12 - .12 4. P r o f e s s i o n a l - .26 .02 - .01 5. S o c i e t a l .10 - .07 .07 6. I n t e r a c t i v e .23 .12 - .13 7. R e l i e f from Boredom and F r u s t r a t i o n - .00 - .02 .03 Age - .07 .08 - .07 M a r i t a l Status .09 .14 .14 T o t a l Number of C h i l d r e n - .01 .07 - .07 Number of Preschool C h i l d r e n - .18 .12 - .12 Number of Elementary School C h i l d r e n - .09 - .02 .02 Number of Secondary School C h i l d r e n .03 .10 - .10 U n i v e r s i t y education experience .16 .08 .08 I n i t i a l education .16 • 1 4 .13 Years s ince graduat ion - .04 .07 - .06 Years a c t i v e nurs ing p r a c t i c e - .05 .09 - .08 Years not p r a c t i c i n g i n nurs ing .00 .00 .01 Length of current employment - .07 .15 - .15 Employment s tatus .23 .18 .17 P o s i t i o n .20 .05 .05 S ing le under l ined values are s i g n i f i c a n t at the .05 l e v e l . Double under l ined values are s i g n i f i c a n t at the .01 l e v e l . a . The values used i n the computing of c o e f f i c i e n t s of c o r r e l a t i o n for these v a r i a b l e s were the percentages of t o t a l p a r t i c i p a t i o n ra ther than the raw sub-index scores . S i g n i f i c a n t r e l a t i o n s h i p s w e r e f o u n d b e t w e e n t o t a l p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s a n d t h r e e o f t h e o r i e n t a t i o n s i d e n t i f i e d f r o m t h e f a c t o r a n a l y s i s o f t h e L e a r n i n g O r i e n t a t i o n I n d e x : L e a r n i n g ; P r o f e s s i o n a l ; a n d I n t e r a c t i v e . T h e h i g h e s t p o s i t i v e r e l a t i o n s h i p w a s w i t h t h e L e a r n i n g O r i e n t a t i o n ( r = . 2 3 , p = . 0 0 0 6 5 ) . T h i s f i n d i n g w a s c o n s i s t e n t w i t h t h e r e s u l t s r e p o r t e d b y b o t h S h e f f i e l d a n d S o v i e w h o a l s o f o u n d p o s i t i v e r e l a t i o n s h i p s b e t w e e n t h e t o t a l a m o u n t o f p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n -i n g a n d t h e l e a r n i n g - o r i e n t e d l e a r n e r s w h i c h t h e y s t u d i e d . T h e o t h e r o r i e n -t a t i o n w h i c h r e l a t e d p o s i t i v e l y t o t o t a l p a r t i c i p a t i o n w a s t h e c l u s t e r o f i t e m s n a m e d I n t e r a c t i v e ( r = . 2 3 , p = . 0 0 0 8 3 ) . W h i l e t h e s e r e s u l t s a r e c o n s i s t e n t w i t h t h e g e n e r a l e x p e c t a t i o n t h a t t h e h i g h e r t h e r e s p o n d e n t s ' s c o r e s o n l e a r n i n g o r i e n t a t i o n s t h e m o r e t h e y w i l l p a r t i c i p a t e i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s , t h e s i g n i f i c a n t n e g a t i v e r e -l a t i o n s h i p b e t w e e n t o t a l p a r t i c i p a t i o n a n d P r o f e s s i o n a l O r i e n t a t i o n c a n n o t b e r e a d i l y e x p l a i n e d . T h e c o e f f i c i e n t o f c o r r e l a t i o n b e t w e e n t h e s e t w o v a r i a b l e s w a s r = - . 2 6 w h i c h i s s i g n i f i c a n t b e y o n d t h e . 0 1 l e v e l ( p = . 0 0 0 0 0 ) . O n l y o n e o r i e n t a t i o n r e l a t e d s i g n i f i c a n t l y t o t h e p a r t i c i p a t i o n s c o r e s i n i n d e p e n d e n t a n d d e p e n d e n t l e a r n i n g a c t i v i t i e s . A s i g n i f i c a n t n e g a t i v e r e l a t i o n s h i p w a s f o u n d t o e x i s t b e t w e e n S o c i a b i l i t y O r i e n t a t i o n a n d p a r t i c i -p a t i o n i n i n d e p e n d e n t a c t i v i t i e s a n d a s i g n i f i c a n t p o s i t i v e c o r r e l a t i o n b e t w e e n t h a t s a m e o r i e n t a t i o n a n d d e p e n d e n t a c t i v i t i e s ( r = - . 1 4 , p = . 0 4 2 4 8 a n d r = . 1 3 , p = . 0 4 2 9 9 r e s p e c t i v e l y ) . T h e s e r e s u l t s a r e t h e r e f o r e c o n s i s t e n t w i t h t h e e x p e c t a t i o n s d i s c u s s e d p r e v i o u s l y . T h o s e l e a r n e r s w h o e n g a g e d i n e d u c a t i o n a l a c t i v i t i e s a s a w a y o f f u l f i l l i n g s o c i a l a n d a f f i l i a t i v e n e e d s p a r t i c i p a t e d m o r e i n d e p e n d e n t t h a n i n d e p e n d e n t l e a r n i n g a c t i v i t i e s . I n a d d i t i o n , s i n c e r e g i s t e r e d n u r s e s w h o a r e i n c l i n e d t o b e e d u c a t i o n a l l y a c t i v e 7 3 f o r t h e e n j o y m e n t o f l e a r n i n g o r i n o r d e r t o a c h i e v e a p a r t i c u l a r p u r p o s e o r g o a l c a n s a t i s f y t h e i r n e e d s i n e i t h e r i n d e p e n d e n t o r d e p e n d e n t l e a r n i n g a c t i v i t i e s , n o s i g n i f i c a n t r e l a t i o n s h i p s w e r e a n t i c i p a t e d between t h e s e p a r t i c u l a r l e a r n i n g o r i e n t a t i o n s a n d t h e s c o r e s o n t h e i n d e p e n d e n t a n d a n d d e p e n d e n t s u b i n d e x e s . T h e t h i r d h y p o t h e s i s s u g g e s t e d t h a t a l l t h e l e a r n i n g o r i e n t a t i o n s d i s p l a y e d b y t h e r e s p o n d e n t s w o u l d b e r e l a t e d t o t h e e x t e n t a n d n a t u r e o f p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s . W h i l e t h i s w a s n o t c o m -p l e t e l y s u b s t a n t i a t e d b y t h e f i n d i n g s , f i v e s i g n i f i c a n t r e l a t i o n s h i p s w e r e i d e n t i f i e d . T h e c o r r e l a t i o n b e t w e e n t h e s c o r e s o n t h e s c a l e m e a s u r i n g t h e r e s p o n d e n t s ' a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n a n d t h e i r t o t a l p a r t i c i p a t i o n s c o r e s w a s f o u n d t o b e s i g n i f i c a n t l y p o s i t i v e ( r = . 3 6 ) b e y o n d t h e . 0 1 l e v e l ( p = . 0 0 0 0 0 ) . H e n c e , t h e n u l l h y p o t h e s i s w a s r e j e c t e d a n d t h e r e s e a r c h h y p o t h e s i s a c c e p t e d . T h e r e f o r e , t h e m o r e f a v o u r a b l e t h e a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n , t h e g r e a t e r r e g i s t e r e d n u r s e s ' t o t a l p a r t i c -i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s . S i g n i f i c a n t r e l a t i o n s h i p s w e r e f o u n d b e t w e e n t o t a l p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s a n d f o u r o f t h e s o c i o - e c o n o m i c v a r i a b l e s i d e n t i f i e d i n h y p o t h e s i s f i v e : n u m b e r o f p r e s c h o o l c h i l d r e n , e d u c a t i o n a l p r e p a r a t i o n , e m p l o y m e n t s t a t u s , a n d p o s i t i o n . L e n g t h o f c u r r e n t e m p l o y m e n t a n d e m p l o y m e n t s t a t u s w e r e t h e o n l y f a c t o r s t h a t e m e r g e d a s h a v i n g s i g n i f i c a n t r e l a t i o n s h i p s w i t h t h e p a r t i c i p a t i o n s c o r e s i n i n d e p e n d e n t a n d d e p e n d e n t l e a r n i n g a c t i v i t i e s . 74 Number of Preschool C h i l d r e n The negat ive r e l a t i o n s h i p between t h i s fac tor and t o t a l p a r t i c i p a -t i o n (r = - .18) which was s i g n i f i c a n t at the .01 l e v e l (p = .00661), i s cons i s tent wi th the f ind ings p r e v i o u s l y reported i n the l i t e r a t u r e ( 31 ) . The demands of fami ly r e s p o n s i b i l i t i e s have been frequent ly i d e n t i f i e d as deterrents to involvement i n continuous l e a r n i n g . Inasmuch as the t o t a l number of c h i l d r e n and the numbers of c h i l d r e n i n elementary and secondary school were not s i g n i f i c a n t l y r e l a t e d to the extent of nurses ' t o t a l p a r t i c -i p a t i o n i n cont inu ing nurs ing educat ion , the f ind ings of t h i s i n v e s t i g a t i o n serve to c l a r i f y more p r e c i s e l y the nature of f a c t o r s which i n h i b i t nurses ' engagement i n continuous l e a r n i n g . The r e s u l t s showed that the more p r e -school c h i l d r e n the respondents had, the l e s s they p a r t i c i p a t e d i n cont inu ing l e a r n i n g a c t i v i t i e s . Educat iona l Prepara t ion While no s i g n i f i c a n t r e l a t i o n s h i p was found to e x i s t between the respondents' i n i t i a l educat ional background and t h e i r t o t a l p a r t i c i p a t i o n i n cont inuing l e a r n i n g a c t i v i t i e s for nurses , a s i g n i f i c a n t p o s i t i v e r e l a -t i onsh ip (r = .16, p = .01881) was e s tab l i shed between t h e i r educat iona l a c t i v i t y and whether or not the respondents had had any u n i v e r s i t y p r e p a r a t i o n . Those r e g i s t e r e d nurses who reported having taken some u n i v e r s i t y courses were found to have p a r t i c i p a t e d more a c t i v e l y than those who had not . While t h i s f i n d i n g i s cons i s tent with the r a t i o n a l e discussed p r e v i o u s l y . The fac t that the nature of the respondent's i n i t i a l education d id not appear to in f luence t h e i r rate of p a r t i c i a t i o n as was expected can only be e x p l a i n e d b y t h e s m a l l n u m b e r o f r e s p o n d e n t s w h o w e r e g r a d u a t e s f r o m b a c -c a l a u r e a t e a n d d i p l o m a p r o g r a m s s p o n s o r e d b y e d u c a t i o n a l i n s t i t u t i o n s . L e n g t h o f C u r r e n t E m p l o y m e n t T h e n u m b e r o f y e a r s t h a t t h e r e s p o n d e n t s w e r e e m p l o y e d i n t h e i r c u r r e n t h o s p i t a l s d i d n o t a p p e a r t o i n f l u e n c e t h e i r t o t a l r a t e o f p a r t i c i -p a t i o n , b u t s i g n i f i c a n t r e l a t i o n s h i p s d i d e x i s t b e t w e e n t h a t f a c t o r a n d t h e i r s c o r e s o n t h e i n d e p e n d e n t a n d d e p e n d e n t a c t i v i t y s u b i n d e x e s . T h e l o n g e r t h e r e s p o n d e n t s h a d w o r k e d i n t h e i r c u r r e n t h o s p i t a l , t h e m o r e t h e y e n g a g e d i n i n d e p e n d e n t l e a r n i n g a c t i v i t i e s a n d t h e l e s s t h e y w e r e i n v o l v e d i n a c t i v i t i e s o f a d e p e n d e n t n a t u r e ( r = . 1 5 , p = . 0 2 4 8 3 a n d r = - . 1 5 , p = . 0 2 7 4 4 r e s p e c t i v e l y . ) O n e e x p l a n a t i o n f o r t h e s e p a r t i c u l a r r e s u l t s m i g h t b e t h a t n u r s e s w h o h a v e w o r k e d i n t h e i r h o s p i t a l f o r o n l y a s h o r t p e r i o d o f t i m e m o r e f r e q u e n t l y a t t e n d d e p e n d e n t a c t i v i t i e s s u c h a s o r i e n t a -t i o n a n d i n s e r v i c e p r o g r a m s w h i c h a r e s p o n s o r e d b y t h e i n s t i t u t i o n t h a n d o n u r s e s w h o h a v e b e e n e m p l o y e d l o n g e r . E m p l o y m e n t S t a t u s E m p l o y m e n t s t a t u s e m e r g e d a s a n o t h e r s o c i o - e c o n o m i c f a c t o r t h a t s e e m e d t o i n f l u e n c e t h e r e s p o n d e n t s ' i n v o l v e m e n t i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s . S i g n i f i c a n t p o s i t i v e r e l a t i o n s h i p s w e r e f o u n d b e t w e e n t h i s i n d e p e n d e n t v a r i a b l e a n d a l l t h r e e d e p e n d e n t v a r i a b l e s . T h e i n t e r p r e t a t i o n o f t h e r e s u l t s i n d i c a t e t h a t p a r t - t i m e r e g i s t e r e d n u r s e s p a r t i c i p a t e d m o r e a c t i v e l y i n c o n t i n u i n g n u r s i n g e d u c a t i o n t h a n d i d f u l l - t i m e e m p l o y e e s . T h e s e p a r t i c u l a r f i n d i n g s w e r e c o n t r a r y t o t h e p a t t e r n s i d e n t i f i e d i n t h e l i t e r a t u r e . T h e s m a l l n u m b e r o f p a r t - t i m e e m p l o y e e s s a m p l e d i n t h i s s t u d y m a y a c c o u n t f o r t h e s e u n e x p e c t e d f i n d i n g s . P o s i t i o n T h e s i g n i f i c a n t p o s i t i v e r e l a t i o n s h i p b e t w e e n t h e r e s p o n d e n t s ' p o s i t i o n a n d t h e i r r a t e o f t o t a l p a r t i c i p a t i o n ( r = . 2 0 , p = . 0 2 7 7 7 ) w a s a n o t h e r f i n d -g i n g t h a t c o i n c i d e d w i t h p r e v i o u s s t u d i e s . R e g i s t e r e d n u r s e s w i t h a d m i n i s -t r a t i v e o r s u p e r v i s o r y r e s p o n s i b i l i t i e s w e r e m o r e a c t i v e l y i n v o l v e d i n c o n -t i n u i n g l e a r n i n g a c t i v i t i e s t h a n w e r e s t a f f n u r s e s . P a r t i c i p a t i o n b y r e g i s t e r e d n u r s e s i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s w a s r e l a t e d t o s e v e r a l s o c i o - e c o n o m i c f a c t o r s , t h e r e f o r e , t h e f i f t h h y p o t h e s i s t h a t p a r t i c i p a t i o n b y r e g i s t e r e d n u r s e s i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s w a s r e l a t e d t o c e r t a i n s o c i o - e c o n o m i c c h a r a c t e r i s t i c s w a s a f f i r m e d . P R E D I C T O R S O F E X T E N T A N D N A T U R E O F P A R T I C I P A T I O N F o r e a c h o f t h e t h r e e d e p e n d e n t v a r i a b l e s ( t o t a l p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s , a n d p a r t i c i p a t i o n i n i n d e p e n d e n t a n d d e p e n -d e n t a c t i v i t i e s ) a m u l t i p l e r e g r e s s i o n a n a l y s i s w a s c o n d u c t e d t o i n v e s t i g a t e h o w m u c h o f t h e v a r i a n c e i n p a r t i c i p a t i o n s c o r e s w a s e x p l a i n e d b y t h e f o l l o w i n g p s y c h o l o g i c a l a n d s o c i o - e c o n o m i c c h a r a c t e r i s t i c s : a t t i t u d e , s e v e n l e a r n i n g o r i e n t a t i o n s , a g e , m a r i t a l s t a t u s , t o t a l n u m b e r o f c h i l d r e n , n u m b e r o f p r e s c h o o l c h i l d r e n , n u m b e r o f c h i l d r e n i n e l e m e n t a r y s c h o o l , n u m b e r o f c h i l d r e n i n s e c o n d a r y s c h o o l , e d u c a t i o n a l p r e p a r a t i o n , y e a r s s i n c e g r a d u a t i o n , y e a r s o f a c t i v e n u r s i n g p r a c t i c e , y e a r s n o t p r a c t i c i n g i n n u r s i n g , l e n g t h o f c u r r e n t e m p l o y m e n t , e m p l o y m e n t s t a t u s a n d p o s i t i o n . T h e S T P R E G r o u t i n e o f t h e U n i v e r s i t y o f B r i t i s h C o l u m b i a ' s T r i a n g u l a r R e g r e s s i o n P a c k a g e ( 7 ) c o m p u t e r p r o g r a m w a s u s e d t o e x e c u t e t h e t h r e e r e g r e s s i o n a n a l y s e s . I n o r d e r t o i n c l u d e t h e n o m i n a l v a r i a b l e s ( m a r i t a l s t a t u s , e d u c a t i o n a l p r e p a r a t i o n , e m p l o y m e n t s t a t u s a n d p o s i t i o n ) , d u m m y v a r i a b l e s w e r e c o n s t r u c t e d u s i n g p a r a m e t r i c p r o c e d u r e s . C a l c u l a t i o n o f a s t e p w i s e r e g r e s s i o n u t i l i z i n g d a t a o b t a i n e d f r o m a l l 2 2 0 r e s p o n d e n t s a n d a f i v e p e r c e n t l e v e l o f s i g n i f i c a n c e d e t e r m i n e d t h a t s i x o f t h e v a r i a b l e s a c c o u n t e d f o r a p p r o x i m a t e l y o n e - q u a r t e r t h e v a r i -a n c e i n t h e t o t a l p a r t i c i p a t i o n s c o r e s . A t t i t u d e s f a v o u r a b l e t o c o n t i n u i n g n u r s i n g e d u c a t i o n a c c o u n t e d f o r t h e l a r g e s t p e r c e n t a g e ( 1 2 . 7 % ) o f t h e v a r i a n c e . I n t h e s u b s e q u e n t f i v e s t e p s t h e f o l l o w i n g v a r i a b l e s i n o r d e r o f p r e d i c t i v e e f f i c i e n c y w e r e e n t e r e d i n t o t h e f i n a l p r e d i c t i o n e q u a t i o n : e m p l o y m e n t s t a t u s ; P r o f e s s i o n a l O r i e n t a t i o n ; I n t e r a c t i v e O r i e n t a t i o n ; u n i v e r s i t y e d u c a t i o n a l e x p e r i e n c e ; a n d L e a r n i n g O r i e n t a t i o n . C o l l e c t i v e l y t h e s i x v a r i a b l e s a c c o u n t e d f o r 2 5 . 3 4 p e r c e n t o f t h e v a r i a n c e i n t o t a l p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s ( T a b l e 1 0 ) . C o r r e l a t i o n o f t h e s e v a r i a b l e s w i t h t h e t o t a l p a r t i c i p a t i o n s c o r e s s h o w e d t h a t t h e a t t i t u d i n a l f a c t o r ( r = . 3 5 6 ) r e l a t e d m o r e h i g h l y t h a n t h e o t h e r c h a r a c t e r i s t i c s , a l t h o u g h a l l w e r e s i g n i f i c a n t a t e i t h e r t h e . 0 1 o r . 0 5 l e v e l ( T a b l e 1 1 ) . I t i s t h e r e f o r e a p p a r e n t t h a t t h e r e s p o n d e n t s ' a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n a c c o u n t e d f o r t h e g r e a t e s t p r o p o r -t i o n o f t o t a l p a r t i c i p a t i o n v a r i a n c e a n d t h a t i t i s t h e b e s t s i n g l e p r e d i c t o r o f n u r s e s ' i n v o l v e m e n t i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s . 78 Table 1 0 Results of Regression Analyses Type of P a r t i c i p a t i o n ^ V a r i a b l e s T o t a l Percentage of Explained Variance T o t a l P a r t i c i p a t i o n A t t i t u d e Toward Cont inuing Nursing Educat ion Employment Status P r o f e s s i o n a l O r i e n t a t i o n I n t e r a c t i v e O r i e n t a t i o n U n i v e r s i t y Educat iona l Experience Learning O r i e n t a t i o n 2 5 . 3 4 Independent A c t i v i t i e s S ta f f Nurse P o s i t i o n Employment Status S o c i a b i l i t y O r i e n t a t i o n 7 . 5 7 Dependent A c t i v i t i e s S ta f f Nurse P o s i t i o n Employment Status S o c i a b i l i t y O r i e n t a t i o n 7 . 4 0 a . L e v e l of S i g n i f i c a n c e ( c * ) = . 0 5 . b . Dependent V a r i a b l e s . Separate analyses were done on the independent and dependent a c t i v i t y subindex scores us ing the same l i s t of p s y c h o l o g i c a l and socio-economic v a r i -a b l e s . In both cases the newly created v a r i a b l e , s t a f f nurse p o s i t i o n , as w e l l as employment s tatus and S o c i a b i l i t y O r i e n t a t i o n were i d e n t i f i e d as f a c t o r s accounting for the var iance i n the p a r t i c i p a t i o n rates i n the two s p e c i f i c kinds of cont inuing l e a r n i n g a c t i v i t i e s - independent and dependent. When p a r t i c i p a t i o n i n independent l e a r n i n g a c t i v i t i e s was set as the dependent v a r i a b l e , the stepwise regress ion rout ine entered s t a f f nurse T a b l e 1 1 C o r r e l a t i o n C o e f f i c i e n t s f o r V a r i a b l e s F o u n d t o A c c o u n t f o r V a r i a n c e i n P a r t i c i p a t i o n S c o r e s ( T o t a l , I n d e p e n d e n t A c t i v i t i e s , a n d D e p e n d e n t A c t i v i t i e s . ) 1 2 3 4 5 6 7 8 9 1 0 1 1 1 . T o t a l P a r t i c i p a t i o n 1 . 0 2 . I n d e p e n d e n t A c t i v i t i e s - . 2 1 2 1 . 0 3 . D e p e n d e n t A c t i v i t i e s . 2 0 4 - . 9 9 9 1 . 0 4 . A t t i t u d e . 3 5 6 - . 0 2 2 . 0 1 9 1 . 0 5 . L e a r n i n g O r i e n t a t i o n . 2 3 2 . 0 0 3 - . 0 0 0 . 3 5 8 1 . 0 6 . P r o f e s s i o n a l O r i e n t a t i o n - . 2 5 8 . 0 1 8 - . 0 1 3 - . 2 1 2 - . 0 4 3 1 . 0 7 . I n t e r a c t i v e O r i e n t a t i o n . 2 2 7 . 1 2 4 - . 1 2 6 . 2 0 6 . 0 2 6 - . 0 4 2 1 . 0 8 . E m p l o y m e n t S t a t u s - . 2 3 0 . 1 7 7 - . 1 7 4 - . 0 4 0 - . 0 2 4 . 0 9 2 - . 0 5 9 1 . 0 9 . U n i v e r s i t y E d u c a t i o n a l E x p e r i e n c e . 1 5 7 - . 0 7 8 . 0 7 8 . 1 7 1 . 1 1 0 . 1 1 5 . 0 6 2 . 0 0 7 1 . 0 1 0 . S t a f f N u r s e - . 0 1 2 - . 1 7 9 . 1 7 6 . 0 3 6 - . 1 0 4 . 0 1 4 - . 1 1 4 - . 0 7 3 - . 0 2 4 1 . 0 1 1 . S o c i a b i l i t y O r i e n t a t i o n . 0 3 8 - . 1 3 5 . 1 3 5 . 1 0 9 . 0 0 6 . 0 0 2 - . 0 2 5 - . 0 1 8 - . 0 6 8 . 0 1 7 1 . 0 S i n g l e u n d e r l i n e d v a l u e s a r e s i g n i f i c a n t a t t h e . 0 5 l e v e l . D o u b l e u n d e r l i n e d v a l u e s a r e s i g n i f i c a n t a t t h e . 0 1 l e v e l . vO 80 position into the prediction equation i n i t i a l l y , and in this f i r s t step explained 3.19 percent of the variance. It then entered employment status followed by Sociability Orientation in the subsequent two steps. Collec-tively these three variables commulatively accounted for 7.57 percent of the variance in the independent subindex scores (Table 10). In the f i n a l regression analysis done on the dependent activity subindex scores, the same three variables were entered into the prediction equation in the same order. The staff nurse position was found to explain 3.11 percent of variance and the third terminal step showed that this factor with employment status and Sociability Orientation accounted for a total of 7.40 percent of the variance in the rates of participation in dependent learning a c t i v i t i e s . While the three variables do not explain as much of the participation variance in dependent a c t i v i t i e s as in independent a c t i v i t i e s , they are nec-essarily the same characteristics due to the 'mirror image' nature of the two sets of subindex scores. The values used in the latter two regression anal-yses were not the raw data but rather the participation rates in independent and dependent learning a c t i v i t i e s expressed as percentages of the total participation scores. Hence these two variables were created to relate inversely to one another. It naturally follows that the factors which predict and relate to the transformed variables would be the same and similarly inversely related. This is clearly illustrated in Table 11. Discussion Insofar as only three psychological and socio-economic variables 8 1 w e r e f o u n d t o e x p l a i n l e s s t h a n 10 p e r c e n t o f t h e v a r i a n c e i n t h e i n d e p e n -d e n t a n d d e p e n d e n t p a r t i c i p a t i o n s c o r e s , l i t t l e k n o w l e d g e o f a n y c o n s e q u e n c e w a s a d d e d t o t h e u n d e r s t a n d i n g o f n u r s e s ' i n v o l v e m e n t i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s o f a n i n d e p e n d e n t a n d d e p e n d e n t n a t u r e . H o w e v e r , i t w a s s h o w n t h a t a n u m b e r o f t h e s e f a c t o r s w e r e p r e d i c t i v e o f t h e r e s p o n d e n t s ' t o t a l p a r t i c i p a t i o n r a t e s . T h e s i g n i f i c a n t p r e d i c t o r s i n c l u d e d b o t h p s y c h o l o g i c a l a n d s o c i o - e c o n o m i c c h a r a c t e r i s t i c w i t h m o r e p s y c h o l o g i c a l t h a n s o c i o - e c o n o m i c f a c t o r s b e i n g e n t e r e d i n t o t h e p r e d i c t i o n e q u a t i o n a n d t h e b e s t s i n g l e p r e -d i c t o r b e i n g a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n . T h e r e s u l t s o f t h e r e g r e s s i o n a n d c o r r e l a t i o n a n a l y s e s s u p p o r t t h e a c c e p t a n c e o f t h e s i x t h h y p o t h e s i s ; n a m e l y , t h e l e a r n i n g o r i e n t a t i o n s a n d a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n w e r e b e t t e r p r e d i c t o r s o f p a r t i c i p a t i o n b y r e g i s t e r e d n u r s e s i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s t h a n w e r e s e l e c t e d s o c i o - e c o n o m i c f a c t o r s . SUMMARY T h i s c h a p t e r h a s d e t a i l e d t h e f i n d i n g s a n d i n t e r p r e t a t i o n o f t h e s t a t i s t i c a l a n a l y s e s c o m p u t e d o n t h e r e s p o n s e s t o t h e 220 c o m p l e t e d q u e s t i o n -n a i r e s . T h e t a b u l a t e d d a t a o b t a i n e d f r o m P a r t D - B i o g r a p h i c a l I n f o r m a t i o n w e r e p r e s e n t e d i n o r d e r t o d e s c r i b e t h e s o c i o - e c o n o m i c c h a r a c t e r i s t i c s o f t h e r e g i s t e r e d n u r s e s s a m p l e d f o r t h i s s t u d y . T h e a n a l y s e s o f t h e r e s p o n s e s t o t h e o t h e r t h r e e s e c t i o n s w e r e t h e n r e p o r t e d o n a c c o r d i n g t o t h e r e s e a r c h h y p o t h e s e s w h i c h w e r e t e s t e d . CHAPTER V SUMMARY, CONCLUSIONS, AND IMPLICATIONS Cont inuing education i s now acknowledged to be an e s s e n t i a l compon-ent of the p r o f e s s i o n a l a c t i v i t i e s of nurses and other h e a l t h p r a c t i t i o n e r s . Only by r e g u l a r l y engaging i n the process of updating and upgrading t h e i r knowledge and s k i l l s can nurses keep pace with the a c c e l e r a t i n g changes o c c u r r i n g i n hea l th care and as a r e s u l t mainta in and enhance t h e i r p r o f e s -s i o n a l competence. Knowledgable and s k i l l e d nurse p r a c t i t i o n e r s are requ ired to provide the q u a l i t y of pa t i en t care deemed d e s i r a b l e by the nurs ing p r o f e s s i o n and the people they serve . A vast array of o p p o r t u n i t i e s for continuous l e a r n i n g are c u r r e n t l y a v a i l a b l e to nurses . However, many of these educat ional programs have been found to be unre la ted to the needs of l e a r n e r s , poor ly planned, and t o t a l l y uncoordinated . L i t t l e research has been done in to the many facets of cont inu ing nurs ing education which r e q u i r e study. As a r e s u l t , the p r o f e s -s ion lacks the necessary knowledge and exper t i se on which to base a r a t i o n a l , comprehensive, and in tegrated approach to the education of i t s members. In a d d i t i o n , i t i s genera l l y held that nurses , l i k e most other h e a l t h p r a c t i t i o n e r s , are not s u f f i c i e n t l y a c t i v e i n cont inu ing t h e i r p r o f e s s i o n a l educat ion . The recent s tudies which have i n i t i a t e d the i n v e s t i g a t i o n of nurses ' involvement i n cont inuing l e a r n i n g a c t i v i t i e s tend to focus on the planned, sys temat ic , t eacher -d i rec t ed forms of educat ion . They do not 82 83 e n c o m p a s s t h e m a n y o p p o r t u n i t i e s f o r s e l f - i n i t i a t e d a n d s e l f - g u i d e d l e a r n i n g . T h e p r i m a r y p u r p o s e o f t h i s s t u d y w a s t o e x p l o r e a n d d e s c r i b e t h e p a r t i c i p a t i o n o f n u r s e s i n b o t h i n d e p e n d e n t ( s e l f - d i r e c t e d ) a n d d e p e n d e n t ( o t h e r - d i r e c t e d ) l e a r n i n g a c t i v i t i e s . I n a d d i t i o n t o i n v e s t i g a t i n g t h e e x t e n t a n d n a t u r e o f n u r s e s ' e n g a g e m e n t i n c o n t i n u i n g n u r s i n g e d u c a t i o n , t h e s t u d y s o u g h t t o e s t a b l i s h t h e r e a s o n s w h y n u r s e s g e t i n v o l v e d , t h e i r a t t i t u d e t o w a r d c o n t i n u i n g t h e i r l e a r n i n g , a n d t h e r e l a t i o n s h i p o f t h e s e f a c t o r s a n d a f e w s e l e c t e d s o c i o - e c o n o m i c f a c t o r s t o t h e i r l e v e l a n d t y p e o f p a r t i c i p a t i o n . T h i s c h a p t e r s u m m a r i z e s t h e s c o p e , d e v e l o p m e n t a n d c o n d u c t o f t h e p r e s e n t s t u d y a n d i t s m a j o r f i n d i n g s . I t a l s o d i s c u s s e s t h e v a r i o u s i m p l i c a t i o n s f o r t h e f u t u r e s t u d y , p l a n n i n g a n d p r o v i s i o n o f c o n t i n u i n g n u r s i n g e d u c a t i o n . S U M M A R Y I n o r d e r t o i n v e s t i g a t e t h e e x t e n t a n d n a t u r e o f n u r s e s ' p a r t i c -i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s f o r n u r s e s , a n d s o m e o f t h e p s y c h o l o g i c a l a n d s o c i o - e c o n o m i c f a c t o r s r e l a t e d t o i t , t h e s u r v e y m e t h o d o f r e s e a r c h w a s u s e d . A q u e s t i o n n a i r e w a s d e v e l o p e d t o c o l l e c t d a t a f r o m a s e l e c t n u r s i n g p o p u l a t i o n i n t h e p r o v i n c e o f B r i t i s h C o l u m b i a a n d a n u m b e r o f s t a t i s t i c a l p r o c e d u r e s w e r e e m p l o y e d t o p r o v i d e a n a l y t i c a l a s w e l l a s d e s c r i p t i v e r e s u l t s . 8 4 M e t h o d o l o g y F e m a l e r e g i s t e r e d n u r s e s e m p l o y e d o n a f u l l - t i m e o r p a r t - t i m e b a s i s b y g e n e r a l h o s p i t a l s i n t h e G r e a t e r V a n c o u v e r a r e a o f B r i t i s h C o l u m b i a c o n s t i t u t e d t h e p o p u l a t i o n o f t h i s s t u d y . F i v e h o s p i t a l s o f m e d i u m s i z e ( 3 0 0 t o 7 0 0 b e d s ) w e r e i n v o l v e d a n d e a c h h a d a d i r e c t o r o r c o o r d i n a t o r o f i n s e r v i c e e d u c a t i o n ( B u r n a b y G e n e r a l H o s p i t a l , L i o n ' s G a t e H o s p i t a l , R o y a l C o l u m b i a n H o s p i t a l , S t . P a u l ' s H o s p i t a l , a n d S u r r e y M e m o r i a l H o s p i t a l ) . A s a m p l e o f 2 5 0 r e g i s t e r e d n u r s e s w e r e r a n d o m l y s e l e c t e d f r o m t h e n u r s i n g s t a f f f i l e s o f t h e p a r t i c i p a t i n g h o s p i t a l s a c c o r d i n g t o a p r o p o r -t i o n a l s t r a t i f i e d s a m p l i n g p r o c e d u r e . A n a d d i t i o n a l 9 3 r a n d o m n a m e s w e r e o b t a i n e d t o p e r m i t r e p l a c e m e n t s n e c e s s i t a t e d b y s a m p l e m o r t a l i t y . A f o u r p a r t q u e s t i o n n a i r e w a s c o n s t r u c t e d t o c o l l e c t t h e d a t a r e q u i r e d f o r t h i s a n a l y t i c a l s u r v e y . P a r t A c o n s i s t e d o f a 2 2 i t e m p a r t i c -i p a t i o n i n d e x f r o m w h i c h a t o t a l p a r t i c i p a t i o n s c o r e a n d t w o s u b - s c o r e s w e r e o b t a i n e d ( p a r t i c i p a t i o n i n i n d e p e n d e n t a n d d e p e n d e n t a c t i v i t i e s ) . A m o d i f i e d f o r m o f t h e A d o l p h - W h a l e y s c a l e w a s u s e d i n P a r t B t o m e a s u r e t h e a t t i t u d e o f n u r s e s t o c o n t i n u i n g n u r s i n g e d u c a t i o n . T h e t h i r d s e c t i o n w a s t h e 5 8 i t e m L e a r n i n g O r i e n t a t i o n I n d e x d e v e l o p e d b y S h e f f i e l d , a n d t h e f i n a l p a r t w a s a s e r i e s o f i t e m s d e s i g n e d t o e l i c i t b i o g r a p h i c a l a n d s o c i o - e c o n o m i c d a t a . P r i o r t o i m p l e m e n t a t i o n , t h e t o t a l i n s t r u m e n t w a s p r e t e s t e d a n d r e v i s e d t o e n s u r e c l a r i t y o f i n t e r p r e t a t i o n a n d a c c u r a c y o f r e s p o n s e . T h e d a t a w e r e i n i t i a l l y c o l l e c t e d i n g r o u p s e s s i o n s s c h e d u l e d a t e a c h o f t h e f i v e h o s p i t a l s . D u e t o t h e i n a d e q u a t e r a t e o f r e t u r n i t w a s n e c e s s a r y t o r e s o r t t o a m a i l i n g p r o c e d u r e w h i c h p r o d u c e d a n a d d i t i o n a l 1 1 0 c o m p l e t e d q u e s t i o n n a i r e s . E v e n t u a l l y a p r o p o r t i o n a l l y d i s t r i b u t e d s a m p l e o f 2 2 0 r e s p o n s e s w a s o b t a i n e d . T h e d a t a w e r e k e y p u n c h e d d i r e c t l y f r o m t h e q u e s t i o n n a i r e s o n t o c o m p u t e r c a r d s a n d a v a r i e t y o f U n i v e r s i t y o f B r i t i s h C o l u m b i a C o m -p u t i n g C e n t r e p r o g r a m s w e r e u s e d t o a n a l y z e t h e d a t a i n o r d e r t o d e s c r i b e t h e c h a r a c t e r i s t i c s o f t h e s a m p l e a n d t e s t t h e v a r i o u s h y p o t h e s e s . F i n d i n g s W h e n a n a l y z i n g t h e d a t a f o r t h e p u r p o s e s o f d e s c r i b i n g t h e s o c i o -e c o n o m i c c h a r a c t e r i s t i c s o f t h e r e s p o n d e n t s , s t a t i s t i c a l t e s t s w e r e d o n e t o e s t a b l i s h w h e t h e r s i g n i f i c a n t d i f f e r e n c e s e x i s t e d b e t w e e n t h e g r o u p s o f n u r s e s f r o m t h e f i v e h o s p i t a l s a n d t h o s e r e s p o n d e n t s w h o c o m p l e t e d t h e q u e s t i o n n a i r e i n g r o u p s e s s i o n s o r b y m a i l . S i n c e o n l y f o u r s i g n i f i c a n t d i f f e r e n c e s w e r e o b t a i n e d , t h e 2 2 0 r e s p o n d e n t s w e r e t r e a t e d a s a t o t a l g r o u p i n a n a l y z i n g a n d i n t e r p r e t i n g t h e d a t a . T h e r e s p o n d e n t s r a n g e d i n a g e f r o m 2 0 t o 6 3 y e a r s w i t h t h e a v e r a g e a g e b e i n g 3 3 . 7 y e a r s . M o r e t h a n h a l f o f t h e r e s p o n d e n t s w e r e m a r r i e d a n d 4 0 . 0 p e r c e n t o f t h e m h a d c h i l d r e n . M o s t o f t h e n u r s e s ( 8 9 . 1 % ) w e r e g r a d u a t e s o f h o s p i t a l d i p l o m a p r o g r a m s , 6 . 8 p e r c e n t r e c e i v e d t h e i r b a s i c e d u c a t i o n f r o m d i p l o m a p r o g r a m s s p o n s o r e d b y e d u c a t i o n a l i n s t i t u t i o n s , a n d o n l y 2 . 3 p e r c e n t w e r e g r a d u a t e s o f b a c c a l a u r e a t e p r o g r a m s . A n a d d i t i o n a l 3 4 r e s p o n -d e n t s r e p o r t e d h a v i n g h a d s o m e u n i v e r s i t y e d u c a t i o n i n e i t h e r n u r s i n g o r n o n - n u r s i n g s u b j e c t s . T h e n u m b e r o f y e a r s s i n c e g r a d u a t i o n r a n g e d f r o m z e r o t o 3 9 w i t h a n a v e r a g e o f 1 1 . 8 , w h i l e t h e n u m b e r o f y e a r s a c t i v e p r a c t i c e v a r i e d f r o m z e r o t o 3 3 w i t h a m e a n o f 9 . 4 . O n l y 1 7 . 7 p e r c e n t o f t h e t o t a l g r o u p h a d n o t b e e n p r a c t i c i n g n u r s i n g f o r f i v e y e a r s o r m o r e . O n e - q u a r t e r o f t h e r e s p o n d e n t s h a d b e e n e m p l o y e d l e s s t h a n t w e l v e m o n t h s a t t h e i r c u r r e n t h o s p i t a l a n d 5 9 . 1 p e r c e n t l e s s t h a n t h r e e y e a r s . A t t h e s a m e t i m e , 1 2 . 7 p e r c e n t h a d w o r k e d i n t h e s a m e h o s p i t a l t e n y e a r s o r m o r e . A l a r g e m a j o r i t y ( 9 2 . 7 % ) o f t h e n u r s e s s a m p l e d w e r e f u l l - t i m e e m p l o y e e s a n d 8 1 . 8 p e r c e n t o f t h e t o t a l g r o u p w e r e s t a f f n u r s e s . E a c h o f t h e 2 2 0 r e s p o n d e n t s p a r t i c i p a t e d i n a t l e a s t o n e o f t h e c o n t i n u i n g l e a r n i n g a c t i v i t i e s i n c l u d e d i n t h e p a r t i c i p a t i o n i n d e x . T h e a v e r a g e t o t a l p a r t i c i p a t i o n s c o r e w a s 9 . 9 w i t h t h e r a n g e o f s c o r e s e x -t e n d i n g f r o m o n e t o s e v e n t e e n . T h e m e a n s c o r e s o n t h e i n d e p e n d e n t a n d d e p e n d e n t s u b i n d e x e s w e r e 5 . 5 a n d 4 . 4 r e s p e c t i v e l y . T h e t - t e s t c a l c u l a t e d o n t h e d i f f e r e n c e b e t w e e n t h e s e t w o m e a n s c o r e s w a s s t a t i s t i c a l l y s i g n i -f i c a n t . T h e s e r e s u l t s w e r e i n t e r p r e t e d t o m e a n t h a t t h e r e s p o n d e n t s d i d p a r t i c i p a t e m o r e i n i n d e p e n d e n t t h a n i n d e p e n d e n t l e a r n i n g a c t i v i t i e s . H e n c e t h e n u l l h y p o t h e s i s w a s r e j e c t e d a n d t h e f i r s t r e s e a r c h h y p o t h e s i s a f f i r m e d . A d d i t i o n a l a n a l y s e s w e r e c o n d u c t e d i n o r d e r t o d e t e r m i n e t h e e x t e n t o f p a r t i c i p a t i o n i n e a c h o f t h e 2 2 c o n t i n u i n g l e a r n i n g a c t i v i t i e s . T h e f i n d i n g s w e r e s u m m a r i z e d , p r e s e n t e d a n d d i s c u s s e d a c c o r d i n g t o t h e t y p e o f a c t i v i t y a n d i n r a n k o r d e r . T h e i n d e p e n d e n t i t e m " R e a d ' q u i c k - r e f e r e n c e ' n u r s i n g l i t e r a t u r e . . . " r a n k e d f i r s t w i t h a p a r t i c i p a t i o n r a t e o f 9 9 . 1 p e r -c e n t a n d t h e l o w e s t r a n k e d i t e m ( 2 . 7 % ) w a s t h e d e p e n d e n t a c t i v i t y " T o o k n u r s i n g ' r e f r e s h e r ' c o u r s e " . A m o r e c o m p r e h e n s i v e a c c o u n t o f t h e r a t e s o f p a r t i c i p a t i o n i n t h e a c t i v i t i e s c a n b e f o u n d i n C h a p t e r I V . I n a s m u c h a s t h e y a r e n o t r e l a t e d t o t h e h y p o t h e s e s , t h e y a r e n o t s u m m a r i z e d h e r e . S e v e n i n t e r p r e t a b l e f a c t o r s w e r e e x t r a c t e d f r o m t h e r e s p o n s e s t o S h e f f i e l d ' s 5 8 i t e m L e a r n i n g O r i e n t a t i o n I n d e x a s a r e s u l t o f t h e p r i n c i p l e c o m p o n e n t s a n a l y s i s w i t h v a r i m a x r o t a t i o n . C o l l e c t i v e l y t h e s e f a c t o r s a c c o u n t e d f o r 4 8 . 2 p e r c e n t o f t h e t o t a l v a r i a n c e a m o n g a l l i t e m s a f t e r r o t a t i o n . A n i n t e r p r e t a t i o n o f t h e i t e m s c l u s t e r i n g i n e a c h f a c t o r c o n -f i r m e d t h e e x i s t e n c e o f b a s i c l e a r n i n g o r i e n t a t i o n s f o r t h i s g r o u p o f a d u l t l e a r n e r s , a n d t h e r e f o r e j u s t i f i e d t h e a c c e p t a n c e o f t h e s e c o n d r e -s e a r c h h y p o t h e s i s . W h i l e t h e o r i e n t a t i o n s w e r e c o n s i s t e n t w i t h H o u l e ' s l e a r n i n g , g o a l , a n d a c t i v i t y - o r i e n t e d c o n s t r u c t s ( 2 5 ) a n d c o m p a r a b l e t o S h e f f i e l d a n d S o v i e ' s r e s u l t s ( 3 6 , 3 7 ) » t h e f i n d i n g s o f t h i s s t u d y w e r e t h a t t h e s e p a r t i c -u l a r n u r s e s w e r e l e a r n i n g , o c c u p a t i o n a l , p r o f e s s i o n a l , s o c i e t a l , s o c i a b i l i t y , i n t e r a c t i v e , a n d r e l i e f f r o m b o r e d o m a n d f r u s t r a t i o n - o r i e n t e d . T h r e e o f t h e s e o r i e n t a t i o n s c o r r e l a t e d s i g n i f i c a n t l y w i t h t h e s c o r e s o n t h e t o t a l p a r t i c i p a t i o n i n d e x . L e a r n i n g a n d I n t e r a c t i v e O r i e n t a t i o n w e r e f o u n d t o r e l a t e p o s i t i v e l y a n d P r o f e s s i o n a l O r i e n t a t i o n r e l a t e d n e g a t i v e l y a t t h e . 0 1 l e v e l . A n a n a l y s i s o f t h e r e l a t i o n s h i p s b e t w e e n t h e s e v e n l e a r n i n g , o r i e n t a t i o n s a n d t h e s c o r e s o n t h e i n d e p e n d e n t a n d d e p e n d e n t a c t i v i t y s u b -i n d e x e s e s t a b l i s h e d t h a t S o c i a b i l i t y O r i e n t a t i o n r e l a t e d n e g a t i v e l y t o p a r t i c i p a t i o n i n i n d e p e n d e n t a c t i v i t i e s a n d p o s i t i v e l y t o p a r t i c i p a t i o n i n d e p e n d e n t a c t i v i t i e s . T h e t h i r d h y p o t h e s i s w a s t h e r e f o r e p a r t i a l l y s u b s t a n t i a t e d s i n c e t h e s e f i v e s i g n i f i c a n t r e l a t i o n s h i p s w e r e i d e n t i f i e d . T h e a n a l y s e s a n d i n t e r p r e t a t i o n o f t h e r e s p o n d e n t ' s s c o r e s o n t h e m o d i f i e d A d o l p h - W h a l e y s c a l e f o u n d t h a t m o s t o f t h e n u r s e s h a d a f a v o u r a b l e a t t i t u d e t o w a r d c o n t i n u i n g n u r s i n g e d u c a t i o n . T h i s p s y c h o l o g i c a l v a r i a b l e r e l a t e d p o s i t i v e l y a n d s i g n i f i c a n t l y t o t h e r e s p o n d e n t s ' t o t a l p a r t i c i p a t i o n s c o r e s , t h e r e b y a f f i r m i n g t h e f o u r t h r e s e a r c h h y p o t h e s i s . 8 8 Among the r e l a t i o n s h i p s s t u d i e d between t o t a l p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s and the v a r i o u s socio-economic v a r i a b l e s , four were i d e n t i f i e d as being s i g n i f i c a n t . The negative r e l a t i o n s h i p between the number of preschool c h i l d r e n and t o t a l p a r t i c i p a t i o n was s i g n i f i c a n t at the .01 l e v e l . E d u c a t i o n a l p r e p a r a t i o n and p o s i t i o n were f a c t o r s which p o s i t i v e l y r e l a t e d to the respondents' t o t a l p a r t i c i p a t i o n i n l e a r n i n g a c t i v i t i e s . Nurses w i t h u n i v e r s i t y e d u c a t i o n a l experience and nurses i n a d m i n i s t r a t i v e or s u p e r v i s o r y p o s i t i o n s p a r t i c i p a t e d more a c t i v e l y than t h e i r c o l l e a g u e s who had not attended u n i v e r s i t y and who were s t a f f nurses. Respondents employed part-time p a r t i c i p a t e d more a c t i v e l y i n i n d e -pendent, dependent and t o t a l c o n t i n u i n g l e a r n i n g a c t i v i t i e s than f u l l - t i m e employees. This was determined by the p o s i t i v e r e l a t i o n s h i p s found between employment s t a t u s and the three p a r t i c i p a t i o n v a r i a b l e s which were a l l s i g n i f i c a n t a t the .01 l e v e l . The l e n g t h of c u r r e n t employment was yet another socio-economic v a r i a b l e which was s i g n i f i c a n t l y r e l a t e d to the independent and dependent subscores although not to the t o t a l p a r t i c i p a t i o n s c o r e s . The longer the respondents worked i n t h e i r current h o s p i t a l , the more they p a r t i c i p a t e d i n independent l e a r n i n g a c t i v i t i e s , and the l e s s they engaged i n dependent a c t i v i t i e s . Inasmuch as the previous s i g n i f i c a n t r e l a t i o n s h i p s were found to e x i s t between the extent and nature of nurses' p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s and s e v e r a l socio-economic c h a r a c t e r i s t i c s , the f i f t h r e search hypothesis was accepted. 8 9 T h e r e s u l t s o f t h e m u l t i p l e r e g r e s s i o n a n a l y s e s w e r e s u c h t h a t t h e s i x t h a n d f i n a l r e s e a r c h h y p o t h e s i s w a s a c c e p t e d ; t h e r e b y , c o n f i r m i n g t h a t t h e l e a r n i n g o r i e n t a t i o n s a n d a t t i t u d e s f a v o u r a b l e t o c o n t i n u i n g n u r s i n g e d u c a t i o n w e r e b e t t e r p r e d i c t o r s o f p a r t i c i p a t i o n b y r e g i s t e r e d n u r s e s i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s t h a n w e r e s e l e c t e d s o c i o - e c o n o m i c f a c t o r s . T h r e e v a r i a b l e s ( s t a f f n u r s e p o s i t i o n , e m p l o y m e n t s t a t u s a n d S o c i a b i l i t y O r i e n t a t i o n ) e n t e r e d i n t o t h e p r e d i c t i o n e q u a t i o n s w h e n p a r t i c i p a t i o n i n i n d e p e n d e n t a n d d e p e n d e n t a c t i v i t i e s w e r e s e t a s t h e d e p e n d e n t v a r i a b l e s . T h e s e f a c t o r s c u m m u l a t i v e l y a c c o u n t e d f o r l e s s t h a n t e n p e r c e n t o f v a r i a n c e s i n t h e t w o p a r t i c i p a t i o n s u b i n d e x s c o r e s . H o w e v e r , w h e n t o t a l p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s w a s s e t a s t h e d e p e n d e n t v a r i a b l e , s i x v a r i a b l e s w e r e e n t e r e d i n t o t h e f i n a l p r e d i c t i o n e q u a t i o n a c c o r d i n g t o t h e f o l l o w i n g o r d e r o f p r e d i c t i v e e f f i c i e n c y : a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n ; e m p l o y m e n t s t a t u s ; P r o f e s s i o n a l O r i e n t a t i o n ; I n t e r a c t i v e O r i e n t a t i o n ; u n i v e r s i t y e d u c a t i o n a l e x p e r i e n c e ; a n d L e a r n i n g O r i e n t a t i o n . C o l l e c t i v e l y t h e s e v a r i a b l e s a c c o u n t e d f o r a p p r o x i -m a t e l y 2 5 p e r c e n t o f t h e t o t a l v a r i a n c e i n p a r t i c i p a t i o n w i t h t h e a t t i t u d i n a l f a c t o r e m e r g i n g a s t h e b e s t s i n g l e p r e d i c t o r . C O N C L U S I O N S T h e m a i n i n t e n t o f t h i s s t u d y w a s t o i n v e s t i g a t e t h e e x t e n t a n d n a t u r e o f r e g i s t e r e d n u r s e s ' p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s . E v e n t h o u g h e v e r y r e s p o n d e n t p a r t i c i p a t e d i n a t l e a s t o n e a c t i v i t y d u r i n g t h e p e r i o d S e p t e m b e r 1 , 1 9 7 2 t o S e p t e m b e r 3 0 , 1 9 7 3 , t h e a v e r a g e n u m b e r o f 90 ac t i v i t i e s engaged in was less than half the number of items in the index. Admittedly, the participation index did not measure the amount of time that nurses were involved in each of the 2 2 selected a c t i v i t i e s , nevertheless, the apparent rate of participation was not particularly high, suggesting that the lack of involvement in continuous learning is a valid concern of the nursing profession. The f i r s t hypothesis tested in this study was that registered nurses participate more in independent than in dependent learning a c t i v i t i e s . The acceptance of this hypothesis and the supporting evidence establishes that nurses do engage in individual and independent forms of learning and that in fact they do so more than they attend formalized educational programs such as short courses, conferences, and workshops. It follows then, that the nursing profession needs to examine more systematically and comprehen-sively the nature of i t s members' involvement in this kind of continuous learning. It must also accord recognition to those nurses who effectively maintain and enhance their professional practice by self-d irected methods and i t must accommodate the learning needs and learning styles of these self-learners as opportunities for continuing nursing education are being planned and developed. With respect to the second hypothesis, i t may be concluded that registered nurses possess the three basic learning orientations described as goal, actively and learning-oriented. The results of this study seemed to expand and c l a r i f y the definition of these orientations. Learning for learning sake (Learning Orientation) continued to be the primary reason iden-t i f i e d why learners participate in educational a c t i v i t i e s . The goal-oriented reasons for learning divided into Occupational Orientation, P r o f e s s i o n a l O r i e n t a t i o n , a n d S o c i e t a l O r i e n t a t i o n , a n d t h e a c t i v i t y o r i e n -t a t i o n w a s d e f i n e d m o r e p r e c i s e l y a s S o c i a b i l i t y , I n t e r a c t i v e a n d R e l i e f f r o m B o r e d o m a n d F r u s t r a t i o n O r i e n t a t i o n . T h e s i g n i f i c a n t r e l a t i o n s h i p s f o u n d b e t w e e n t h r e e o f t h e s e o r i e n -t a t i o n s a n d t h e e x t e n t a n d n a t u r e o f r e g i s t e r e d n u r s e s ' p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s i n d i c a t e s , a t l e a s t i n p a r t , t h a t n u r s e s ' i n v o l v e m e n t i n c o n t i n u i n g e d u c a t i o n i s i n f l u e n c e d b y t h e i r n e e d s a n d i n t e r e s t s . A s e x p e c t e d , n u r s e s w h o a r e a c t i v i t y - o r i e n t e d p a r t i c i p a t e m o r e i n d e p e n d e n t a c t i v i t i e s w h i c h p r o v i d e o p p o r t u n i t i e s f o r s o c i a l a n d i n t e r -p e r s o n a l c o n t a c t s . T h e l a c k o f i n t e r a c t i o n b e t w e e n l e a r n i n g a n d g o a l -o r i e n t a t i o n s a n d p a r t i c i p a t i o n s u p p o r t s t h e c o n v i c t i o n t h a t l e a r n e r s w h o e n g a g e i n l e a r n i n g f o r t h e s e r e a s o n s c a n s a t i s f y t h e i r n e e d s i n e i t h e r i n d e p e n d e n t o r d e p e n d e n t l e a r n i n g s i t u a t i o n s . T h e s i g n i f i c a n t n e g a t i v e r e l a t i o n s h i p b e t w e e n P r o f e s s i o n a l O r i e n t a t i o n a n d p a r t i c i p a t i o n l e v e l s r a i s e s i m p o r t a n t q u e s t i o n s t o b e a n s w e r e d i n f u t u r e s t u d i e s . T h e f o u r t h h y p o t h e s i s p e r t a i n e d t o t h e a t t i t u d e o f r e g i s t e r e d n u r s e s t o c o n t i n u i n g n u r s i n g e d u c a t i o n . T h e f i n d i n g s i n d i c a t e t h a t t h e r e s p o n d e n t s h a d a g e n e r a l l y f a v o u r a b l e a t t i t u d e t o c o n t i n u i n g n u r s i n g e d u c a t i o n a n d t h a t t h e m o r e f a v o u r a b l e t h e a t t i t u d e , t h e g r e a t e r t h e i r t o t a l p a r t i c i p a t i o n i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s . W h i l e t h e r e s u l t s c o n f i r m e d t h e e x p e c t a t i o n t h a t . t h e p s y c h o l o g i c a l v a r i a b l e s i n f l u e n c e t h e e x t e n t a n d n a t u r e o f r e g i s t e r e d n u r s e s ' p a r t i c i -p a t i o n i n c o n t i n u o u s l e a r n i n g , t h e y s h o w e d t h a t a n u m b e r o f t h e s o c i o -e c o n o m i c c h a r a c t e r i s t i c s a r e r e l a t e d a s w e l l . O n t h e b a s i s o f t h i s s t u d y a n d p r e v i o u s r e s e a r c h , i t m a y b e c o n c l u d e d t h a t t h e n u m b e r o f c h i l d r e n n u r s e s h a v e , e s p e c i a l l y p r e s c h o o l e r s , a n d t h e i r p o s i t i o n i n n u r s i n g c l e a r l y 92 affect their involvement in continuing education. Once again educational preparation emerged as an influential factor but the precise contribution of this variable to the variance in participation has yet to be determined. The higher rate of involvement of part-time nurses in continuing learning a c t i v i t i e s was unexpected and contrary to previous research find-ings. The influence of length of current employment on participation in independent and dependent a c t i v i t i e s was another contributing factor that was d i f f i c u l t to explain. Further study i s indicated in relation to these last two characteristics. The significant findings of the correlation analyses and the multiple regression analyses indicate that certain variables are useful i n explaining and predicting the extent to which nurses participate in continuing learning a c t i v i t i e s . The amount of specific variance in participation i n the inde-pendent and dependent a c t i v i t i e s explained by three of the variables (staff nurse position, employment status and Sociability Orientation) was not sufficient to j u s t i f y the formation of any firm conclusions. However, six of the participant characteristics were found to explain one-quarter of the variance in the total participation scores. Two of these (employment status and university educational experience) were socio-economic in nature, the remaining ones were psychological. Nurses' attitude to con-tinuing their professional education emerged as the best.single predictor of their participation in continuous learning for nurses. While some socio-economic factors obviously relate to the involve-ment of nurses in continuing education, others such as age and marital status no longer appear to do so. As expected the psychological variables of attitude and motivation appear to be more c r i t i c a l determinants of whether 93 nurses participate in continuing their learning and to what extent. In future research focused on continuing nursing education, i t would appear that attention should be directed to only those c r i t i c a l psychological and specific socio-economic factors which have been shown in this study and supported by previous investigations to influence nurses' learning behaviour. This would necessitate the development and refinement of more valid and reliable instruments. IMPLICATIONS FOR CONTINUING NURSING EDUCATION Each of the registered nurses surveyed in this study participated at least to some extent in continuing learning a c t i v i t i e s over the past year, and as a group, they were found to be motivated by certain needs and interests to advance their knowledge and s k i l l s . In addition, most of them demonstrated a favourable attitude to continuing nursing education. To an extent, these findings are encouraging and provide evidence of the commitment of some nurses to the need for continuing education and their willingness to become actively involved in the ongoing process of renewing their personal and professional competence. Nevertheless, the nursing profession aspires to a universally high standard of performance on the part of i t s members as a means of achieving the highest quality of nursing care possible. In order to achieve this goal nurses must continually be involved in efforts to update and upgrade their professional practice. 94 The results of this study suggest that nurses must be guided and assisted not only to maintain but also to increase their participation in continuous learning a c t i v i t i e s . It was found that, on the average, the nurses engaged in less than half the number of dependent and independent a c t i v i t i e s accessible to them. The survey instrument was limited to mea-suring the number of a c t i v i t i e s engaged in by the registered nurses over the past year, hence, the amount of time devoted to each activity is another dimension that needs to be investigated. The findings of such research could conceivably alter markedly the conclusions drawn from the present study. In the f i n a l analysis, the number of ac t i v i t i e s in which nurses par-ticipate and the amount of time they spend is of l i t t l e consequence i f they learn nothing and their behaviour remains unchanged. Hence, future nursing research focusing on continuing nursing education must address i t s e l f to the problem of determining whether and to what extent nurses are learning as a result of involvement in continuing learning a c t i v i t i e s , what additional learning experiences they require, and whether any substantive changes ensue in their performance and the quality of care they provide. In the meantime, this particular study provides some rather conclu-sive evidence and raises some specific questions that suggest immediate steps which need to be taken by nurses in the province of British Columbia and by the nursing profession generally- Whereas every nurse reported involvement in an independent learning activity of one sort or another, and whereas, i t was clearly shown that nurses.participated more in independent than dependent learning a c t i v i t i e s , i t i s c r i t i c a l that more be known about this particular method of continuous learning. It is equally important that definite action be taken to improve the quality and expand the a v a i l a b i l i t y of both independent 95 a n d d e p e n d e n t c o n t i n u i n g l e a r n i n g a c t i v i t i e s . T h i s r e l a t e s t o t h e p r o g r a m p l a n n i n g a n d i m p l e m e n t a t i o n o f o p p o r t u n i t i e s f o r c o n t i n u o u s l e a r n i n g . W i t h r e s p e c t t o t h e n e e d f o r r e s e a r c h r e l a t e d t o i n d i v i d u a l a n d i n d e p e n d e n t m o d e s o f l e a r n i n g , a n u m b e r o f q u e s t i o n s a n d i s s u e s e m e r g e . D o s o m e n u r s e s p r e f e r t o i n i t i a t e a n d d i r e c t t h e i r o w n l e a r n i n g r a t h e r t h a n a t t e n d c o u r s e s , w o r k s h o p s a n d c o n f e r e n c e s p l a n n e d a n d g u i d e d b y o t h e r s ? I f s o , w h a t c h a r a c t e r i s t i c s d i f f e r e n t i a t e t h e s e l f - d i r e c t e d l e a r n e r s f r o m t h e p r o g r a m - a t t e n d e r s ? W h a t s k i l l s a r e r e q u i r e d t o e n g a g e s u c c e s s f u l l y i n s e l f - d i r e c t e d l e a r n i n g a n d h o w c a n t h e s e c a p a b i l i t i e s b e t a u g h t t o t h o s e w h o b y p r e f e r e n c e o r n e c e s s i t y w i s h t o l e a r n i n t h i s w a y ? ( 1 2 ) . W h a t d i f f i c u l t i e s d o s e l f - l e a r n e r s e n c o u n t e r a n d w h a t r e s o u r c e s a r e r e q u i r e d t o o v e r c o m e t h e s e p r o b l e m s ? ( 4 0 ) . F i n a l l y , i n w h a t w a y c a n t h e n u r s i n g p r o -f e s s i o n f o r m a l l y a c k n o w l e d g e a n d p r o v i d e r e c o g n i t i o n f o r t h e k n o w l e d g e a n d s k i l l s a c q u i r e d b y t h i s e q u a l l y v a l i d m e t h o d o f l e a r n i n g ? I f t h e n u r s i n g p r o f e s s i o n i n t e n d s t o i n c r e a s e s u b s t a n t i a l l y t h e a c -t i v e i n v o l v e m e n t o f i t s m e m b e r s i n c o n t i n u i n g l e a r n i n g a c t i v i t i e s , i t m u s t c o m e t o t e r m s w i t h t h e i s s u e o f n u r s e s ' a t t i t u d e s t o c o n t i n u i n g n u r s i n g e d u c a t i o n . T h i s s t u d y h a s d e m o n s t r a t e d t h a t t h e a t t i t u d e o f n u r s e s t o w a r d c o n t i n u i n g t h e i r e d u c a t i o n i s v e r y m u c h r e l a t e d t o t h e i r i n v o l v e m e n t i n l e a r n -i n g a c t i v i t i e s . T h e m o r e f a v o u r a b l e t h e i r a t t i t u d e , t h e m o r e t h e y p a r t i c i p a t e d . I t f o l l o w s , t h a t a m o r e c o n c e r t e d e f f o r t m u s t b e m a d e t o f o s t e r s u c h a n a t t i -t u d e i n e a c h a n d e v e r y n u r s e p r a c t i t i o n e r . T h i s m e a n s s o c i a l i z i n g p o t e n t i a l p r a c t i t i o n e r s t o a p h i l o s o p h y o f l i f e - l o n g l e a r n i n g f r o m t h e t i m e t h e y e n t e r b a s i c n u r s i n g e d u c a t i o n p r o g r a m s . I t e n t a i l s e x p o s i n g s t u d e n t n u r s e s t o a n e d u c a t i o n a l e n v i r o n m e n t o r i e n t e d t o c o n t i n u o u s l e a r n i n g a n d t h e p r o v i s i o n o f s u i t a b l e r o l e m o d e l s w h o a r e t h e m s e l v e s c o n t i n u o u s l e a r n e r s . A c t i v e l y 9 6 i n v o l v i n g n u r s e s i n c o n t i n u i n g e d u c a t i o n e x p e r i e n c e s w h i l e t h e y a r e s t i l l s t u d e n t s w o u l d b e o n e w a y o f i n i t i a t i n g t h e m t o t h e i m p o r t a n c e a n d n e c e s s i t y o f c o n t i n u o u s l e a r n i n g a s a p r o f e s s i o n a l r e s p o n s i b i l i t y . I t i s e q u a l l y e s s e n t i a l t h a t a l l g r a d u a t e n u r s e s b e b r o u g h t t o a h i g h e r l e v e l o f a w a r e n e s s , u n d e r s t a n d i n g , a n d a p p r e c i a t i o n o f t h e i r n e e d t o e n g a g e i n a n o n g o i n g p r o g r a m o f p r o f e s s i o n a l d e v e l o p m e n t . E v e r y o p p o r t u -n i t y m u s t b e t a k e n t o i n f o r m n u r s e s o f t h e i m p o r t a n c e o f c o n t i n u i n g e d u c a t i o n . S u p p o r t a n d e n c o u r a g e m e n t m u s t a l s o b e p r o v i d e d i n t h e f o r m o f f i n a n c i a l a s s i s t a n c e , e d u c a t i o n a l l e a v e a n d r e c o g n i t i o n o f a c h i e v e m e n t . T h e p r o f i l e a n d i m p a c t o f c u r r e n t a n d f u t u r e c o n t i n u i n g n u r s i n g e d u -c a t i o n p r o g r a m s a n d r e s o u r c e s i s a c r i t i c a l d e t e r m i n a n t o f n u r s e s ' a c c e p t a n c e o f a n d a d h e r e n c e t o a c o m m i t m e n t o f a c t i v e i n v o l v e m e n t i n c o n t i n u o u s l e a r n i n g . I n d i v i d u a l l y a n d c o l l e c t i v e l y , t h e n u r s i n g p r o f e s s i o n , i t s m e m b e r s , a n d i t s c l i e n t s , m u s t e x p e r i e n c e t h e b e n e f i t s a n d w o r t h o f s u c h e d u c a t i o n a l e n d e a v o u r s . T h a t r e q u i r e s t h a t t h e v a r i o u s o p p o r t u n i t i e s f o r c o n t i n u o u s l e a r n i n g m u s t b e e d u c a t i o n a l l y s o u n d , w e l l o r g a n i z e d , e c o n o m i c a l l y a n d g e o g r a p h i c a l l y a c c e s s i b l e a n d , m o s t o f a l l , r e s p o n d e n t t o t h e n e e d s a n d i n t e r e s t s o f t h e l e a r n e r s . T h i s s t u d y h a s d e m o n s t r a t e d t h a t n u r s e s a r e g e n e r a l l y i n t e r e s t e d i n l e a r n i n g f o r i t s o w n s a k e , a s a m e a n s o f a t t a i n i n g s p e c i f i c o c c u p a t i o n a l , p r o f e s s i o n a l a n d s o c i e t a l g o a l s , a n d a s a w a y o f m e e t i n g c e r t a i n p e r s o n a l a n d s o c i a l n e e d s . A l l o f t h e s e r e a s o n s m u s t b e b o r n e i n m i n d w h e n p l a n n i n g v a r -i o u s l e a r n i n g o p p o r t u n i t i e s f o r n u r s e s . I n p a r t i c u l a r , t i m e n e e d s t o b e p r o -v i d e d f o r t h e e x c h a n g e o f o p i n i o n s a n d i d e a s i n b o t h i n d e p e n d e n t a n d d e p e n d e n t l e a r n i n g s i t u a t i o n s . T h e f a c t t h a t g e n e r a l d u t y o r s t a f f n u r s e s d o n o t a p p e a r t o p a r t i c i p a t e a s a c t i v e l y a s d o n u r s e s i n s u p e r v i s o r y p o s i t i o n s s u g g e s t t h a t c u r r e n t e d u c a t i o n a l o p p o r t u n i t i e s m a y n o t a d e q u a t e l y a c c o m m o d a t e t h e n e e d s a n d c i r c u m s t a n c e s o f t h i s l a r g e g r o u p o f n u r s i n g m a n p o w e r . A l s o , n u r s e s w i t h p r e s c h o o l c h i l d r e n w e r e i n v o l v e d i n l e a r n i n g a c t i v i t i e s l e s s t h a n t h o s e w i t h o u t c h i l d r e n o r t h o s e w h o s e c h i l d r e n w e r e o l d e r a n d p r e s u m a b l y r e q u i r e d l e s s s u p e r v i s i o n . W h i l e t h e p r o v i s i o n o f c h i l d c a r e f a c i l i t i e s w o u l d b e o n e w a y o f e n c o u r a g i n g t h e i n v o l v e m e n t o f n u r s e s w i t h y o u n g c h i l d r e n , a n o t h e r s o l u t i o n w o u l d b e t o e x p a n d a n d i m p r o v e t h e o p p o r t u n i t i e s a n d r e s o u r c e s f o r i n d e p e n d e n t m e t h o d s o f l e a r n i n g . T h e p r o v i s i o n o f c o m m u n i t y - b a s e d s u p p o r t s e r v i c e s s u c h a s c o u n s e l l i n g , g u i d a n c e a n d l i b r a r y f a c i l i t i e s , a n d t h e d e v e l o p m e n t a n d r e f i n e m e n t o f i n d i v i d u a l i z e d i n s t r u c t i o n a l m a t e r i a l s s u c h a s m o d u l e s , a u d i o - v i s u a l p r o g r a m s , a n d c o r r e s p o n d e n c e c o u r s e s w o u l d p r o m o t e m o r e a c t i v e p a r t i c i p a t i o n o n t h e p a r t o f s t a f f n u r s e s w o r k i n g s h i f t , n u r s e s i n g e o g r a p h i c a l l y i s o l a t e d a r e a s a n d n u r s e s w i t h c o n f l i c t i n g f a m i l y a n d s o c i a l i n t e r e s t s . W h i l e r e s e a r c h i n t o i n d i v i d u a l a n d i n d e p e n d e n t c o n t i n u o u s l e a r n i n g a n d t h e d e v e l o p m e n t a n d i m p l e m e n t a t i o n o f r e l e v a n t , a c c e s s i b l e a n d e f f e c t i v e l e a r n i n g o p p o r t u n i t i e s r e q u i r e t h e i m m e d i a t e a t t e n t i o n o f t h e n u r s i n g p r o -f e s s i o n i n B r i t i s h C o l u m b i a a n d e l s e w h e r e , a d d i t i o n a l r e s e a r c h a n d d e v e l o p -m e n t g o a l s m u s t b e s e t f o r t h e n e a r f u t u r e . M u c h m o r e n e e d s t o b e k n o w n w i t h r e s p e c t t o t h e c o n t i n u i n g e d u c a t i o n o f n u r s i n g p e r s o n n e l n o t i n c l u d e d i n t h i s o r p r e v i o u s s t u d i e s . T h e p r o f e s s i o n h a s y e t t o r e s p o n d a d e q u a t e l y t o t h e u n i q u e l e a r n i n g n e e d s a n d a c t i v i t i e s o f p r a c t i c a l n u r s e s , m a l e n u r s e s , c a s u a l a n d r e l i e f s t a f f a n d p r i v a t e d u t y n u r s e s . N o r , h a s i t f o c u s e d m u c h a t t e n t i o n o n n u r s e s w o r k i n g i n s e t t i n g s o t h e r t h a n g e n e r a l h o s p i t a l s . S p e -c i a l t y h o s p i t a l s , p u b l i c h e a l t h a g e n c i e s , o c c u p a t i o n a l h e a l t h c e n t r e s , m e d i c a l o f f i c e s , o u t p o s t s , a n d s c h o o l s o f n u r s i n g u n d o u b t e d l y c r e a t d i f f e r e n t 98 c l i n i c a l a n d f u n c t i o n a l l e a r n i n g n e e d s f o r t h e i r p e r s o n n e l . T h i s s t u d y h a s a l s o s h o w n t h a t v a l i d a n d r e l i a b l e i n s t r u m e n t s f o r m e a s u r i n g a t t i t u d i n a l a n d m o t i v a t i o n a l v a r i a b l e s i n a n u r s i n g c o n t e x t n e e d t o b e d e v e l o p e d , a n d i t h a s r a i s e d t h e q u e s t i o n a s t o w h a t i s t h e m o s t e f f e c t i v e a n d e f f i c i e n t m e t h o d o f c o l l e c t i n g d a t a f r o m a n u r s i n g g r o u p . S k i l l e d c o n t i n u i n g n u r s i n g e d u c a t o r s a r e n e e d e d t o p l a n a n d d e v e l o p q u a l i t y c o n t i n u i n g n u r s i n g e d u c a t i o n , t o i n c o r p o r a t e t h e r e s u l t s o f p r e v i o u s a n d c u r r e n t i n v e s t i g a t i o n s , a n d t o i n i t i a t e a d d i t i o n a l r e s e a r c h . T h e s e e d u c a t o r s m u s t b e k n o w l e d g a b l e a n d s k i l l e d i n t h e a p p l i c a t i o n o f t h e o r i e s a n d m e t h o d o l o g i e s p e r t i n e n t t o a d u l t l e a r n i n g . T h e y a l s o n e e d t o b e c r e a t i v e , r e s o u r c e f u l a n d a d a p t a b l e t o w o r k i n g i n a n e d u c a t i o n a l s y s t e m t h a t o u t o f n e c e s s i t y i s f l e x i b l e a n d e v e r c h a n g i n g . O n l y w i t h t h e d e v e l o p m e n t a n d s u p -p o r t o f s u c h l e a d e r s h i p c a n t h e n u r s i n g p r o f e s s i o n a c h i e v e i t s u l t i m a t e g o a l , n a m e l y , t h e p r o v i s i o n o f e x c e l l e n t n u r s i n g s e r v i c e t o a l l c l i e n t s b y k n o w -l e d g a b l e a n d p r o f e s s i o n a l l y c o m p e t e n t n u r s e p r a c t i t i o n e r s . REFERENCES 9 9 1 0 0 R E F E R E N C E S 1 . A d o l p h , T . a n d R . F . W h a l e y . " A t t i t u d e s T o w a r d A d u l t E d u c a t i o n , " A d u l t E d u c a t i o n , 1 7 : 1 5 2 - 1 5 9 , ( S p r i n g , 1 9 6 7 ) . 2 . A n d e r s o n , N o r m a n H . " S c a l e s a n d S t a t i s t i c s : P a r a m e t r i c a n d N o n p a r a m e t r i c , " P s y c h o l o g i c a l B u l l e t i n , 5 8 ( 4 ) : 3 0 5 - 3 1 6 , 1 9 6 1 . 3 . B a r t e r , M a r i o n I. a n d K a t h l e e n R u a n e . C o n t i n u i n g E d u c a t i o n f o r N u r s e s . A S t u d y o f t h e N e e d f o r C o n t i n u i n g E d u c a t i o n  f o r R e g i s t e r e d N u r s e s i n O n t a r i o . T o r o n t o : S c h o o l o f N u r s i n g a n d t h e D i v i s i o n o f U n i v e r s i t y E x t e n s i o n , U n i v e r s i t y o f T o r o n t o , 1 9 6 9 . 4 . B e n n e t , L e l a n d , R . " A i r F o r c e N u r s e s ' P a r t i c i p a t i o n i n P r o g r a m s o f C o n t i n u i n g E d u c a t i o n . " U n p u b l i s h e d D o c t o r a l d i s s e r t a t i o n , B o s t o n U n i v e r s i t y , 1 9 6 8 . 5 . B e r g , H e l e n M . " F a c t o r s D i f f e r e n t i a t i n g P a r t i c i p a n t a n d N o n P a r t i c i p a n t N u r s e s i n C o n t i n u i n g E d u c a t i o n . " U n p u b l i s h e d D o c t o r a l d i s s e r t a t i o n , T e a c h e r s C o l l e g e , C o l u m b i a U n i v e r s i t y , 1 9 7 3 . 6 . B e v i s , M a r y E . " R o l e C o n c e p t i o n a n d t h e C o n t i n u i n g L e a r n i n g A c t i v i t i e s o f N e o p h y t e C o l l e g i a t e N u r s e s . " U n p u b l i s h e d D o c t o r a l d i s s e r t a t i o n , U n i v e r s i t y o f C h i c a g o , 1 9 7 1 . 7 . B j e r r i n g , J a m e s H . a n d P a u l S e a g r e a v e s . U B C T R I P T r i a n g u l a r R e g r e s s i o n P a c k a g e . V a n c o u v e r : C o m p u t i n g C e n t r e , T h e U n i v e r s i t y o f B r i t i s h C o l u m b i a , 1 9 7 2 . 8 . B o n e a u , C . A l a n . " A N o t e o n M e a s u r e m e n t S c a l e s a n d S t a t i s t i c a l T e s t s , " A m e r i c a n P s y c h o l o g i s t , 1 6 : 2 6 0 - 2 6 1 , 1 9 6 1 . 9 . B r u n n e r , E d m u n d d e S . a n d o t h e r s . A n O v e r v i e w o f A d u l t E d u c a t i o n R e s e a r c h . W a s h i n g t o n : A d u l t E d u c a t i o n A s s o c i a t i o n o f t h e U . S . A . , 1 9 5 9 . 1 0 . B u r g e s s , P a u l D . " T h e E d u c a t i o n a l O r i e n t a t i o n s o f A d u l t P a r t i c i p a n t s i n G r o u p E d u c a t i o n a l A c t i v i t i e s . " U n p u b l i s h e d D o c t o r a l d i s s e r t a -t i o n , U n i v e r s i t y o f C h i c a g o , 1 9 7 1 . 1 1 . C a n a d i a n H o s p i t a l D i r e c t o r y . T o r o n t o : C a n a d i a n H o s p i t a l A s s o c i a t i o n , 1 9 7 3 . 1 2 . C l a r k , K a t h l e e n M . " I n d e p e n d e n t L e a r n i n g A C o n c e p t A n a l y s i s , " i n P r o c e e d i n g s o f a C o n f e r e n c e o n I n d e p e n d e n t L e a r n i n g . V a n c o u v e r : A d u l t E d u c a t i o n R e s e a r c h C e n t r e a n d D i v i s i o n o f C o n t i n u i n g E d u c a t i o n i n t h e H e a l t h S c i e n c e s , T h e U n i v e r s i t y o f B r i t i s h C o l u m b i a , 1 9 7 3 . 1 0 1 1 3 . C o l l a r t , M a r i e E . " C o m p u t e r A s s i s t e d I n s t r u c t i o n a n d t h e T e a c h i n g -L e a r n i n g P r o c e s s , " N u r s i n g O u t l o o k , 2 1 : 5 2 7 - 5 3 2 , ( A u g u s t , 1 9 7 3 ) . 1 4 . C o o p e r , S i g n e S . a n d M a y S . H o r n b a c k . T h e C o n t i n u i n g L e a r n e r i n N u r s i n g . W i s c o n s i n : U n i v e r s i t y o f W i s c o n s i n , D e p a r t m e n t o f N u r s i n g , U n i v e r s i t y E x t e n s i o n , 1 9 6 6 . 1 5 . C o o p e r , S i g n e S . , a n d M a y S . H o r n b a c k . C o n t i n u i n g N u r s i n g E d u c a t i o n . N e w Y o r k : M c G r a w - H i l l B o o k C o . , 1 9 7 3 . 1 6 . C r u m p , M u r i e l . P e r s o n a l c o r r e s p o n d e n c e w i t h t h e N u r s i n g C o o r d i n a t o r , R o y a l C o l u m b i a n H o s p i t a l . D e c e m b e r , 1 9 7 3 . 1 7 . C u r t i s s , F r i e d a S . , a n d o t h e r s . C o n t i n u i n g E d u c a t i o n i n N u r s i n g . B o u l d e r , C o l o r a d o : W e s t e r n I n t e r s t a t e C o m m i s s i o n f o r H i g h e r E d u c a t i o n , 1 9 6 9 . 1 8 . C u t s h a l l , P a t r i c i a . P e r s o n a l c o r r e s p o n d e n c e . O c t o b e r , 1 9 7 3 . 1 9 . D u b i n , S a m u e l S . , ( e d . ) . P r o f e s s i o n a l O b s o l e s c e n c e . L e x i n g t o n : L e x i n g t o n B o o k s , D . C . H e a t h a n d C o . , 1 9 7 1 . 2 0 . F a u r e , E d g a r , a n d o t h e r s . L e a r n i n g t o b e . P a r i s : U N E S C O , 1 9 7 2 . 2 1 . F l a h e r t y , M . J o s e p h i n e . " A n E n q u i r y i n t o t h e N e e d f o r C o n t i n u i n g E d u c a t i o n f o r R e g i s t e r e d N u r s e s i n t h e P r o v i n c e o f O n t a r i o . " U n p u b l i s h e d M . A . t h e s i s , U n i v e r s i t y o f T o r o n t o , 1 9 6 5 . 2 2 . F o r n i , P a t r i c i a R . " T r e n d s i n . L i c e n s u r e a n d C e r t i f i c a t i o n , " J o u r n a l o f N u r s i n g A d m i n i s t r a t i o n , 3 ( 5 ) : 1 7 - 2 3 , ( S e p t e m b e r -O c t o b e r , 1 9 7 3 ) . 2 3 . H a l m , J a s o n . 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Stephan, F r e d e r i c k F . and P h i l i p J . McCarthy. Sampling Opinions An A n a l y s i s of Survey Procedure. New York: John Wiley and Sons, 1958. 39. Stevens, Barbara J . "Mandatory Cont inuing Educat ion for Pro^-f e s s i o n a l Nurse R e l i c e n s u r e . What are the Issues? ," J o u r n a l  of Nursing A d m i n i s t r a t i o n , 3(5): 25-28, (September-October, 1973). 40. Tough, A l l e n M. Learning Without A Teacher A Study of Tasks and Ass i s tance During Adult Se l f -Teaching P r o j e c t s . Toronto: The Ontario I n s t i t u t e For Studies In Educat ion , 1967. 41. Tough, A l l e n M. Why Adul ts Learn A Study of the Major Reasons for  Beginning and Cont inuing a Learning P r o j e c t . Toronto: The Ontario I n s t i t u t e For Studies In Educat ion , 1968. APPENDICES 1 0 3 A p p e n d i x A T H E U N I V E R S I T Y O F B R I T I S H C O L U M B I A 1 0 4 V A N C O U V E R 8, C A N A D A A d u l t E d u c a t i o n R e s e a r c h C e n t r e F A C U L T Y O F E D U C A T I O N J u l y 2 4 , 1 9 7 3 D e a r I a m a g r a d u a t e s t u d e n t a t t h e A d u l t E d u c a t i o n R e s e a r c h C e n t r e , U . B . C . a n d o v e r t h e p a s t y e a r I h a v e b e e n s t u d y i n g u n d e r t h e d i r e c t i o n o f D r . C o o l i e V e r n e r a n d M r s . M a r g a r e t N e y l a n . C u r r e n t l y I ' m w o r k i n g o n m y t h e s i s w h i c h i n v o l v e s a s t u d y o f r e g i s t e r e d n u r s e s ' p a r t i c i p a t i o n i n c o n t i n u i n g n u r s i n g e d u c a t i o n . I w o u l d l i k e t o r e q u e s t y o u r a s s i s t a n c e w i t h t h i s p r o j e c t . T h e p u r p o s e o f t h i s s t u d y i s t o a n s w e r t h e f o l l o w i n g q u e s t i o n s : 1 . W h a t i s t h e n a t u r e a n d e x t e n t o f r e g i s t e r e d n u r s e s ' p a r t i c i p a t i o n i n c o n t i n u i n g n u r s i n g l e a r n i n g a c t i v i t i e s o f p a r t i c u l a r t y p e s ? 2 . W h a t a r e t h e o r i e n t a t i o n s o f r e g i s t e r e d n u r s e s t o w a r d c o n t i n u o u s l e a r n i n g ? 3 . W h a t a r e t h e a t t i t u d e s o f r e g i s t e r e d n u r s e s t o w a r d c o n t i n u o u s n u r s i n g e d u c a t i o n ? 4 . W h a t a r e t h e i n t e r r e l a t i o n s h i p s b e t w e e n r e g i s t e r e d n u r s e s ' p a r t i c i p a t i o n i n c o n t i n u i n g n u r s i n g l e a r n i n g a c t i v i t i e s a n d t h e i r o r i e n t a t i o n s t o w a r d c o n t i n u o u s l e a r n i n g , t h e i r a t t i t u d e s t o w a r d c o n t i n u i n g n u r s i n g e d u c a t i o n , a n d c e r t a i n d e m o g r a p h i c c h a r a c t e r i s t i c s o f t h e p a r t i c i p a n t s . I h a v e c h o s e n a s m y p o p u l a t i o n , r e g i s t e r e d n u r s e s e m p l o y e d i n m e d i u m s i z e g e n e r a l h o s p i t a l s w h i c h a r e l o c a t e d i n t h e G r e a t e r V a n c o u v e r a r e a a n d w h i c h h a v e n u r s i n g p e r s o n n e l r e s p o n s i b l e f o r p l a n n i n g a n d i m p l e m e n t i n g p r o g r a m s o f i n s e r v i c e e d u c a t i o n . D u r i n g t h e m o n t h o f S e p t e m b e r , 1 9 7 3 I w i l l w a n t t o a d m i n i s t e r a q u e s t i o n n a i r e t o g r o u p s o f r a n d o m l y s e l e c t e d r e g i s t e r e d n u r s e s . W o u l d i t b e p o s s i b l e t o o b t a i n a s a m p l e o f r e g i s t e r e d n u r s e s f r o m y o u r s t a f f t o p a r t i c i p a t e i n t h i s s t u d y ? W o u l d i t b e p o s s i b l e a l s o f o r m e t o h a v e a c c e s s t o l i s t s o f r e g i s t e r e d n u r s e s o n y o u r s t a f f i n o r d e r t h a t I m i g h t s e l e c t a n a p p r o p r i a t e s a m p l e ? I f s o , w o u l d y o u k i n d l y p r o v i d e m e w i t h a n e s t i m a t e o f t h e n u m b e r o f r e g i s t e r e d n u r s e s t h a t y o u e x p e c t t o h a v e o n y o u r s t a f f i n t h e f a l l . I f y o u h a v e a n y q u e s t i o n s , p l e a s e c o n t a c t m e a t t h e A d u l t E d u c a t i o n R e s e a r c h C e n t r e T h a n k y o u f o r c o n s i d e r i n g t h i s r e q u e s t . Y o u r s s i n c e r e l y , A p p e n d i x B T H E U N I V E R S I T Y O F B R I T I S H C O L U M B I A V A N C O U V E R 8, C A N A D A 1 0 5 A d u l t E d u c a t i o n R e s e a r c h C e n t r e , FACULTY OF EDUCATION N o v e m b e r 9 , 1 9 7 3 . D e a r I a m c o n d u c t i n g a s t u d y o f r e g i s t e r e d n u r s e s ' p a r t i c i p a t i o n i n c o n t i n u i n g n u r s i n g e d u c a t i o n . . T h e p u r p o s e o f t h i s p r o j e c t i s t o o b t a i n i n f o r m a t i o n w h i c h w i l l b e h e l p f u l i n t h e f u t u r e p l a n n i n g o f r e l e v a n t a n d u s e f u l c o n t i n u i n g n u r s i n g e d u c a t i o n p r o g r a m s i n B r i t i s h C o l u m b i a . I n o r d e r t o c o l l e c t t h i s I n f o r m a t i o n , I w i l l b e a d m i n i s t e r i n g a q u e s t i o n n a i r e t o g r o u p s o f r e g i s t e r e d n u r s e s i n f i v e o f t h e g e n e r a l h o s p i t a l s l o c a t e d i n t h e G r e a t e r V a n c o u v e r a r e a . Y o u r n a m e w a s r a n d o m l y s e l e c t e d f r o m a l i s t o f n u r s e s p r o v i d e d b y , D i r e c t o r o f N u r s i n g a t H o s p i t a l . I w o u l d a p p r e c i a t e i t i f y o u w o u l d a s s i s t w i t h t h i s s t u d y b y c o m p l e t i n g o n e o f t h e q u e s t i o n n a i r e s . I w i l l b e v i s i t i n g y o u r h o s p i t a l o n t h e f o l l o w i n g d a t e s : D a t e T i m e P l a c e o r o r o r T h e s e t i m e p e r i o d s ( 2 . 3 0 t o 3 . 1 5 o r 3 . 4 5 t o 4 . 3 0 ) w e r e s e l e c t e d s o t h a t i f y o u a r e o n d a y o r e v e n i n g s h i f t o n t h e d a t e s s p e c i f i e d y o u w i l l b e a b l e t o a t t e n d t h e a p p r o p r i a t e s e s s i o n o n y o u r o f f - d u t y t i m e . ( i . e . D a y s t a f f - 3 . 4 5 t o 4 . 3 0 ; E v e n i n g s t a f f - 2 . 3 0 t o 3 . 1 5 . ) T h e q u e s t i o n n a i r e r e q u i r e s o n l y t h i r t y ( 3 0 ) m i n u t e s t o c o m p l e t e b u t f o r t y - f i v e ( 4 5 ) m i n u t e s h a v e b e e n s c h e d u l e d t o a l l o w f o r e x p l a n a t i o n s a n d q u e s t i o n s . I f i t i s n o t p o s s i b l e f o r y o u t o a t t e n d a n y o n e o f t h e a b o v e g r o u p s e s s i o n s p l e a s e c o n t a c t m e s o t h a t w e c a n a r r a n g e a m o r e c o n v e n i e n t t i m e . A l l r e s p o n s e s w i l l b e t r e a t e d c o n f i d e n t i a l l y . M a n y t h a n k s f o r y o u r c o n s i d e r a t i o n o f t h i s r e q u e s t . Y o u r s s i n c e r e l y , A p p e n d i x C 106 C O N T I N U I N G E D U C A T I O N Q U E S T I O N N A I R E F O R R E G I S T E R E D N U R S E S G u i d e l i n e s f o r a n s w e r i n g t h e q u e s t i o n n a i r e Y o u r r e s p o n s e t o t h e f o l l o w i n g q u e s t i o n s w i l l p r o v i d e i n f o r m a t i o n r e g a r d i n g y o u r i n v o l v e m e n t i n c o n t i n u i n g n u r s i n g l e a r n i n g a c t i v i t i e s o v e r t h e p a s t y e a r , y o u r a t t i t u d e t o w a r d c o n t i n u i n g n u r s i n g e d u c a t i o n , a n d y o u r r e a s o n s f o r c o n t i n u i n g y o u r l e a r n i n g . T h i s i n f o r m a t i o n w i l l b e u s e f u l i n h e l p i n g t h o s e n u r s e s r e s p o n s i b l e f o r p r o v i d i n g c o n t i n u i n g n u r s i n g e d u c a t i o n p l a n a v a r i e t y o f r e l e v a n t p r o g r a m m e s . W h e n a n s w e r i n g t h e q u e s t i o n s p l e a s e d o t h e f o l l o w i n g : 1 . R e a d a l l t h e i n s t r u c t i o n s a n d e a c h q u e s t i o n c a r e f u l l y . 2 . S o m e q u e s t i o n s a s k i n g f o r o p i n i o n s m a y r e q u i r e s o m e t h o u g h t b u t a t t e m p t t o a n s w e r i n t e r m s o f y o u r f i r s t . i m p r e s s i o n . Y o u r i m m e d i a t e r e a c t i o n s a r e t h e o n e s w e w a n t , s o d o n ' t s p e n d t o o m u c h t i m e o n a n y p a r t i c u l a r i t e m . 3 . P l e a s e d o n o t h e s i t a t e t o a s k q u e s t i o n s a t a n y t i m e o f t h e p e r s o n a d m i n i s t e r i n g t h e q u e s t i o n n a i r e . Y o u r a n s w e r s w i l l b e k e p t s t r i c t l y c o n f i d e n t i a l . T h a n k y o u f o r c o o p e r a t i n g i n t h i s s t u d y . P A R T . A - P A R T I C I P A T I O N I N D E X 1 0 7 I n s t r u c t i o n s : T h e f o l l o w i n g i s a p a r t i a l l i s t o f l e a r n i n g a c t i v i t i e s . P l a c e a n X i n t h e a p p r o p r i a t e c o l u m n t o i n d i c a t e w h e t h e r o r n o t y o u h a v e e n g a g e d i n e a c h o f t h e s e a c t i v i t i e s o v e r t h e p a s t y e a r ( S e p t e m b e r 1 , 1 9 7 2 t o S e p t e m b e r 3 0 , 1 9 7 3 ) . L E A R N I N G A C T I V I T I E S D I D P A R T I C I P A T E D I D N O T P A R T I C I P A T E P a r t i c i p a t e d i n a d i s c u s s i o n o f y o u r p e r s o n a l p e r f o r m a n c e e v a l u a t i o n . A t t e n d e d n o n - c r e d i t s h o r t c o u r s e ( s ) , W o r k s h o p ( s ) , a n d c o n f e r e n c e ( s ) s p o n s o r e d b y t h e D i v i s i o n o f C o n t i n u i n g N u r s i n g E d u c a t i o n , S c h o o l o f N u r s i n g , U . B . C . A t t e n d e d h o s p i t a l - w i d e i n s e r v i c e p r o g r a m m e ( s ) . E n g a g e d i n d i v i d u a l l y i n d a y - t o - d a y p r o -b l e m s o l v i n g i n n u r s i n g c a r e s i t u a t i o n ( s ) . A s s i s t e d w i t h p r o f e s s i o n a l r e s e a r c h o r s t u d y p r o j e c t ( s ) . D i d p r o g r a m m e d i n s t r u c t i o n p a c k a g e ( s ) . ( e . g . A m e r i c a n J o u r n a l o f N u r s i n g i t e m s o n h o s t i l i t y a n d a n x i e t y . ) D i d a f o r m a l s e l f - e v a l u a t i o n o f n u r s i n g p e r f o r m a n c e i n o r d e r t o i d e n t i f y s t r e n g t h s a n d a r e a s f o r f u r t h e r d e v e l o p m e n t . D i d a s e l f - i n i t i a t e d a n d s e l f - d i r e c t e d s t u d y p r o j e c t o n a p a r t i c u l a r t o p i c . D i d i n d i v i d u a l s t u d y p a c k e t ( s ) . ( e . g . " E m o t i o n a l n e e d s o f t h e h o s p i t a l i z e d p r e - s c h o o l c h i l d " b y J . K o t a s k a . ) A t t e n d e d n o n - c r e d i t s h o r t c o u r s e ( s ) , w o r k -s h o p ( s ) a n d c o n f e r e n c e ( s ) • s p o n s o r e d i n t e r -p r o f e s s i o n a l l y b y t h e D i v i s i o n o f C o n t i n u i n g E d u c a t i o n i n t h e H e a l t h S c i e n c e s , U . B . C . A t t e n d e d w a r d / u n i t i n s e r v i c e p r o g r a m m e ( s ) . I n i t i a t e d a n d d i r e c t e d p r o f e s s i o n a l r e s e a r c h a n d s t u d y p r o j e c t ( s ) . P r e p a r e d f o r i n s t r u c t i n g p a t i e n t s a n d o t h e r h o s p i t a l s t a f f . A t t e n d e d c e r t i f i c a t e c l i n i c a l c o u r s e ( s ) . ( e . g . O . R . p r o g r a m m e a t S t . P a u l ' s H o s p i t a l ; P h a s e 1 1 - I n t e n s i v e a n d C o r o n a r y C a r e c o u r s e s p o n s o r e d b y t h e D i v i s i o n o f C o n t i n u i n g N u r s i n g E d u c a t i o n , S c h o o l o f N u r s i n g , U . B . C . ) _ 9 _ LEARNING ACTIVITIES CONT'D DID PARTICIPATE 108 DID NOT PARTICIPATE FOR OFFICE USE ONLY Attended ward/unit o r i e n t a t i o n programme(s) Read "quick r e f e r e n c e " n u r s i n g l i t e r a t u r e such as p o l i c y and procedure manuals, drug manuals, p r o f e s s i o n a l pamphlets, and brochures. Took n u r s i n g " r e f r e s h e r " course. Read other (non-nursing) p r o f e s s i o n a l j o u r n a l s and textbooks. Attended h o s p i t a l - w i d e o r i e n t a t i o n programme(s). P a r t i c i p a t e d i n c r e d i t course(s) o f f e r e d by the School of Nursing, U.B.C. Read p r o f e s s i o n a l n u r s i n g j o u r n a l s and textbooks. Used a u d i o - v i s u a l m a t e r i a l s such as v i d e o -tapes, audio-tapes, loop f i l m s , and s l i d e -tape p r e s e n t a t i o n s which have not been made a v a i l a b l e as p a r t of an i n s e r v i c e , o r i e n t a t i o n , or c l a s s programme. PART B - ATTITUDES TO CONTINUING NURSING EDUCATION I n s t r u c t i o n s : The s c a l e below i s designed to r e f l e c t your general a t t i t u d e toward c o n t i n u i n g n u r s i n g education. P l a c e an X on the l i n e provided to i n d i c a t e where you t h i n k you belong. S t r o n g l y favourable to Continuing Nursing Education Favourable Undecided Unfavourable _ i S t r o n g l y unfavourable to Continuing Nursing Education _ 4 3 , 4 4 - 3 -PART B - con't. Instructions: 109 FOR OFFICE USE ONLY The following l i s t of statements express opinions about continuing nursing education. Place an X on the appropriate l i n e to in d i c a t e to what extent you agree or disagree with each statement. Strongly Strongly Agree Agree Undecided Disagree Disagree The need for continuing nursing education i s g r e a t l y exaggerated by those who stand to gain from i t most. Continuing nursing education never has and never w i l l do anything for me. A nurse's learning a b i l i t y remains constant throughout her l i f e t i m e . Graduate nurses cannot memorize as e a s i l y as younger student nurses. Continuing nursing education i s j u s t another f i n a n c i a l l i a b i l i t y . The benefits of continuing nursing education are too obscure to j u s t i f y i t . Continuing nursing education i s the answer to the problem of unemployment i n nursing. Continuing nursing education i s unnecessary since one can get a l l the information needed from books. Further nursing education increases one's s e l f - c o n f i d e n c e . Most continuing nursing education courses are too expensive. Continuing nursing education must be terminated immediately. Graduate nurses l e a r n as e a s i l y as younger student nurses. Continuing nursing education i s j u s t as important as basic nursing education. Continuing nursing education i s f i n e i f you have the time. 4 5 5 0 55 J>8 - 4 -P A R T B - c o n t ' d , 110 S t r o n g l y S t r o n g l y A g r e e A g r e e U n d e c i d e d D i s a g r e e D i s a g r e e I t h i n k t h e c o n t r o v e r s y o v e r c o n t i n u i n g n u r s i n g e d u c a t i o n i s a l i t t l e e x a g g e r a t e d a s t o t h e s e r i o u s n e s s o f t h e n e e d . C o n t i n u i n g n u r s i n g e d u c a t i o n c o u r s e s l a c k c o n t e n t a n d w a s t e t i m e o n n o n - e s s e n t i a l s . C a n a d a s h o u l d i n v e s t m o r e m o n e y i n c o n t i n u i n g n u r s i n g e d u c a t i o n . C o n t i n u i n g n u r s i n g e d u c a t i o n r e q u i r e s t o o m u c h t i m e a n d e f f o r t . ( A d o l p h a n d W h a l e y s c a l e - m o d i f i e d ) F O R O F F I C E U S E O N L Y 59 _ 6 2 6 3 , 6 4 P A R T C - C O N T I N U I N G L E A R N I N G O R I E N T A T I O N I N D E X I n s t r u c t i o n s : . . . c - v ... . • J • J _ • j - • c T h i s s e c t i o n o f t h e q u e s t i o n n a i r e i s d e s i g n e d t o i d e n t i f y y o u r r e a s o n s f o r p a r t i c i p a t i n g i n a l l t y p e s o f e d u c a t i o n a l a c t i v i t i e s . P l e a s e c o n s i d e r n o t o n l y y o u r r e a s o n s f o r e n g a g i n g i n c o n t i n u i n g n u r s i n g e d u c a t i o n b u t a l s o o t h e r f o r m s o f a d u l t e d u c a t i o n s u c h a s n i g h t s c h o o l c l a s s e s a n d c o m m u n i t y c e n t r e e d u c a t i o n a l p r o g r a m m e s . S o m e t i m e s y o u m a y f e e l a s t h o u g h y o u h a v e h a d t h e s a m e i t e m b e f o r e . T h i s w i l l n o t b e t h e c a s e , s o d o n o t l o o k b a c k a n d f o r t h t h r o u g h t h e i t e m s . D o n o t t r y t o r e m e m b e r h o w y o u c i r c l e d s i m i l a r i t e m s e a r l i e r . M a k e e a c h i t e m a s e p a r a t e a n d i n d e p e n d e n t j u d g e m e n t . T h i n k i n g b a c k o v e r y o u r t o t a l e d u c a t i o n a l a c t i v i t i e s o f t h e p a s t y e a r , w h a t r e a s o n s f o r p a r t i c i p a t i n g s e e m t o b e t h e m o s t m e a n i n g f u l f o r y o u ? R e a d e a c h s t a t e m e n t c a r e f u l l y a n d c i r c l e o n e o f t h e n u m b e r s (5, v e r y f r e q u e n t l y i m p o r t -a n t f o r m e ; 4 , f r e q u e n t l y i m p o r t a n t f o r m e ; 3 , s o m e t i m e s i m p o r t a n t f o r m e ; 2 , s e l d o m i m p o r t a n t f o r m e ; 1, n e v e r i m p o r t a n t f o r m e ) o p p o s i t e e a c h s t a t e m e n t . E x a m p l e : V e r y f r e q u e n t l y i m p o r t a n t f o r m e F r e q u e n t l y i m p o r t a n t f o r m e S o m e t i m e s i m p o r t a n t f o r m e S e l d o m i m p o r t a n t f o r m e N e v e r i m p o r t a n t f o r m e ( C i r c l e t h e n u m b e r t h a t a p p l i e s f o r e a c h s t a t e m e n t ) T o f i l l a d e e p , r i c h c u r i o u s i t y a b o u t l i f e a n d i d e a s . I f y o u f e e l t h a t t h i s s t a t e m e n t i s " f r e q u e n t l y i m p o r t a n t f o r m e " - c i r c l e ( 4 ; a s i n d i c a t e d . - 5 -B E G I N H E R E 1 1 1 Q u e s t i o n : T h i n k i n g b a c k o v e r y o u r t o t a l e d u c a t i o n a l a c t i v i t i e s o f t h e p a s t y e a r , w h a t r e a s o n s f o r p a r t i c i p a t i n g s e e m t o b e t h e m o s t m e a n i n g f u l f o r y o u ? V e r y f r e q u e n t l y F r e q u e n t l y S o m e t i m e s S e l d o m N e v e r i m p o r t a n t i m p o r t a n t i m p o r t a n t i m p o r t a n t i m p o r t a n t f o r m e f o r m e f o r m e f o r m e f o r m e T o r e t r a i n f o r v o c a t i o n a l c h a n g e s . T o b e w i t h f r i e n d s a n d a s s o c i a t e s . T o d e v e l o p c r e a t i v e e x p r e s s i o n ( a r t , m u s i c , d a n c e , s p e a k i n g , e t c . ) T o e n j o y i n d i v i d u a l l y o r i e n t e d a c t i v i t i e s . T o s a t i s f y a n i n n a t e n e e d f o r i n f o r m a t i o n a n d k n o w l e d g e . T o p a r t i c i p a t e i n a c t i v i t i e s t h a t a r e c o m p l e t e l y n e w t o m e . T o s e e k h e l p f u l i n -s i g h t s a b o u t h u m a n r e l a t i o n s h i p s . T o p u r s u e a p a t h o f i n t e l l e c t u a l c u r i o u s i t y . T o e x c h a n g e i d e a s a n d i n f o r m a t i o n . T o a s s o c i a t e w i t h o t h e r s o f s i m i l a r i n t e r e s t s . ( C i r c l e t h e n u m b e r t h a t a p p l i e s f o r e a c h s t a t e m e n t ) T o e n j o y t h e s a t i s f a c t i o n t h a t c o m e s f r o m l e a r n i n g . - 6 -P A R T C - c o n t ' d . 1 1 2 Q u e s t i o n : T h i n k i n g b a c k o v e r y o u r t o t a l e d u c a t i o n a l a c t i v i t i e s o f t h e p a s t y e a r , w h a t r e a s o n s f o r p a r t i c i p a t i n g s e e m t o b e t h e m o s t m e a n i n g f u l f o r y o u ? V e r y f r e q u e n t l y F r e q u e n t l y S o m e t i m e s S e l d o m N e v e r i m p o r t a n t i m p o r t a n t i m p o r t a n t i m p o r t a n t i m p o r t a n t f o r m e f o r m e f o r m e f o r m e f o r m e T o f u l f i l l a n e e d f o r p e r s o n a l a s s o c i a t i o n s a n d f r i e n d s h i p s . T o c o m p e n s a t e f o r u n f a v o u r a b l e a c c e p t a n c e b y a s s o c i a t e s . T o i n t r o d u c e m e t o n e w i d e a s w h i c h I c a n f u r t h e r e x p l o r e o n m y o w n . T o f i l l a n e c o n o m i c m o t i v a t i o n . T o f i l l a n i n n a t e y e a r n i n g f o r k n o w l e d g e . T o u n d e r t a k e g r o u p p a r t i c i p a t i o n s a s a s o c i a l l y a c c e p t a b l e c h a n g e f r o m i s o l a t e d i n d i v i d u a l s t u d y . T o g a i n r e c o g n i t i o n a m o n g p e e r s . T o s e e k r e l i e f f r o m b o r e d o m . T o f u r t h e r e x p o s e a n i n s a t i a b l y c u r i o u s m i n d . ( C i r c l e t h e n u m b e r t h a t a p p l i e s f o r e a c h s t a t e m e n t ) T o u n d e r s t a n d c o m m u n i t y p r o b l e m s . T o m a k e n e w f r i e n d s . T o s e c u r e p r o f e s s i o n a l a d v a n c e m e n t . 5 5 4 4 3 3 1 1 P A R T C - c o n t ' d . 1 1 3 Q u e s t i o n : T h i n k i n g b a c k o v e r y o u r t o t a l e d u c a t i o n a l a c t i v i t i e s o f t h e p a s t y e a r , w h a t r e a s o n s f o r p a r t i c i p a t i n g s e e m t o b e t h e m o s t m e a n i n g f u l f o r y o u ? V e r y f r e q u e n t l y F r e q u e n t l y S o m e t i m e s S e l d o m N e v e r i m p o r t a n t i m p o r t a n t i m p o r t a n t i m p o r t a n t i m p o r t a n t f o r m e . f o r m e . f o r m e . f o r m e . f o r m e . T o g e t t h e s a t i s -f a c t i o n o f a c c o m p l i s h m e n t . T o e x p e r i e n c e t h e p l e a s u r e o f m e e t i n g n e w p e o p l e . T o d e s i r e e n l i g h t e n -m e n t . T o s a t i s f y a d e s i r e t o b e a c t i v e . T o s a t i s f y i n t e l l e c t -u a l c u r i o s i t y . T o c l a r i f y w h a t I w i s h t o b e d o i n g 5 o r 1 0 y e a r s f r o m n o w . T o s a t i s f y a n i n q u i r i n g m i n d . T o b e c o m e a m o r e e f f e c t i v e c i t i z e n . T o b e c o m e a c q u a i n t e d w i t h c o n g e n i a l p e o p l e . T o e n j o y t h e p l e a s u r e o f d i s c o u r s e . T o i n c r e a s e c o m p e t e n c e i n e m p l o y m e n t . T o s t u d y f o r i t s o w n s a k e . T o o v e r c o m e t h e f r u s t r a t i o n o f d a y - t o -d a y l i v i n g . ( C i r c l e t h e n u m b e r t h a t a p p l i e s f o r e a c h s t a t e m e n t ) 3 3 3 3 3 3 3 3 3 3 - 8 -PART C - cont'd, 114 Question: Thinking back over your t o t a l e d u c a t i o n a l a c t i v i t i e s of the past year, what reasons f o r p a r t i c i p a t i n g seem to be the most meaningful f o r you? Very f r e q u e n t l y Frequently Sometimes Seldom Never important important important important important f o r me. f o r me. f o r me. f o r me. f o r me. To f i n d i n t e l l e c t u a l enrichment and s t i m -u l a t i o n . To l e a r n b e t t e r ways of doing t h i n g s . To engage i n the d i s -c u s s i o n of i d e a s . To b e l i e v e that the a c t i v i t y p r o v i d e s r e s p e c t a b i l i t y . To seek to con-t r i b u t e to the Hommon good". To f e e l a s o c i a l need to be a p a r t of an accepted group. To s a t i s f y a deep c u r i o s i t y about l i f e and i d e a s . To develop under-standing . To use l e a r n i n g s i t u a t i o n s f o r s o c i a l purposes. ( C i r c l e the number that a p p l i e s f o r each statement) FOR OFFICE USE ONLY To d e s i r e to l e a r n and to know. 5 To prepare f o r s e r v i c e i n the community. 5 To p a r t i c i p a t e i n education as an end i n i t s e l f . 5 4 4 - 9 -PART C - cont'd. 115 Question: Thinking back over your total educational a c t i v i t i e s of the past year, what reasons for participating seem to be the most meaningful for you? Very frequently Frequently Sometimes Seldom Never important important important important important for me. for me. for me. for me. for me. To feel a need to be accepted by others. To undertake edu-cation as a means to an end. To undertake an activity with a friend. To feel a need for more education. To enjoy socially oriented learning a c t i v i t i e s . To enjoy seeking knowledge. To use education as a means to higher status and prestige. To enjoy the association with other people. To up-grade occupational competency. (Circle the number that applies for each statement) FOR OFFICE USE ONLY To enjoy acquiring more knowledge. (Sheffield Index) - 10 -116 I n s t r u c t i o n s : PART D - BIOGRAPHICAL INFORMATION Please f i l l i n the blanks and place an X i n the appro p r i a t e squares. 1. Name of employing h o s p i t a l ; 2. Age i n years: M a r i t a l s t a t u s : a. b. c. S i n g l e M a r r i e d Other (separated, d i v o r c e d , widowed) 4, 5, 6. 7. T o t a l number of c h i l d r e n : Number of pre-school c h i l d r e n : Number of c h i l d r e n i n primary/elementary school: Number of c h i l d r e n i n secondary s c h o o l : I n i t i a l e d u c a t i o n a l p r e p a r a t i o n i n nursing: a. | H o s p i t a l diploma program b. I I Diploma program sponsored by a post-secondary e d u c a t i o n a l i n s t i t u t i o n such as B.C.I.T., V.C.C., Langa c. | | Baccalaureate degree program. d. | j Other (please s p e c i f y : • ) 9. Year of graduation; 10. Have you had any a d d i t i o n a l u n i v e r s i t y education (diploma, c e r t i f i c a t e , degree) i n e i t h e r n u r s i n g or non-nursing s u b j e c t s : a. | | Yes (please s p e c i f y : b. | | No ) FOR OFFICE USE ONLY 1,3 3 4 5 - 11 -PART D - cont'd. 11. Number of years of a c t i v e p r a c t i c e as a r e g i s t e r e d nurse: 117 12. Length of time employed i n t h i s p a r t i c u l a r h o s p i t a l : (yrs.) (mths.) 13. Employment s t a t u s : a. F u l l - t i m e b. | Part-time 14. Average number of hours worked per week: 15. 16, T i t l e of your p o s i t i o n : a. j j S t a f f Nurse b. | | Head Nurse or A s s i s t a n t Head Nurse c. | [ Supervisor d. | | Other (please s p e c i f y : ) Percentage of worktime spent s u p e r v i s i n g other n u r s i n g s t a f f : FOR OFFICE USE ONLY (% estimate) 17. C l i n i c a l s p e c i a l t y : a. | | M e d i c a l - S u r g i c a l b. | i Obstetrics/Gynecology P e d i a t r i c s P s y c h i a t r y Extended C a r e / G e r i a t r i c s d. e. f. Acute Care (I.C.U., C.C.U., Emerg., O.R./P.A.R.) Other (please s p e c i f y : COMMENTS: 49 54 Thank You j A p p e n d i x D F a c t o r L o a d i n g s o n E i g h t F a c t o r s a n d C o m m u n a l i t i e s R e s u l t i n g f r o m P r i n c i p l e C o m p o n e n t s A n a l y s i s w i t h V a r i m a x R o t a t i o n o f D a t a f r o m L e a r n i n g O r i e n t a t i o n I n d e x 3 L e a r n i n g O r i e n t a t i o n I n d e x I t e m V a r i a b l e s F a c t o r s C o m m u n a l i t y I I I I I I I V V V I V I I V I I I 1 . T o r e t r a i n f o r v o c a t i o n a l c h a n g e s . . 2 3 . 0 8 * . 4 4 - . 1 4 - . 1 8 - . 0 8 . 0 7 - . 2 7 . 3 8 2 . T o b e w i t h f r i e n d s a n d a s s o c i a t e s . - . 0 8 * - . 6 5 . 1 5 . 0 2 - . 0 6 . 1 2 . 0 7 - . 0 8 . 4 8 3 . T o d e v e l o p c r e a t i v e e x p r e s s i o n ( a r t , m u s i c , d a n c e , s p e a k i n g , e t c . ) . 2 0 - . 1 4 . 0 9 . 0 1 - . 0 6 . 0 2 - . 0 2 * - . 4 6 . 2 6 4 . T o e n j o y i n d i v i d u a l l y o r i e n t e d a c t i v i t i e s . . 0 8 - . 2 0 . 1 3 . 0 8 . 0 4 . 1 2 . 0 1 * - . 4 4 . 2 8 5 . T o s a t i s f y a n i n n a t e n e e d f o r i n f o r m a t i o n a n d k n o w l e d g e . * . 5 7 - . 0 0 . 0 9 - . 1 1 - . 0 9 . 2 0 . 1 0 - . 2 3 . 4 6 6 . T o p a r t i c i p a t e i n a c t i v i t i e s t h a t a r e c o m p l e t e l y n e w t o m e . . 2 0 . 0 3 . 0 1 - . 2 3 . 0 6 . 3 5 - . 1 2 - . 3 8 . 3 8 7 . T o s e e k h e l p f u l i n s i g h t s a b o u t h u m a n r e l a t i o n s h i p s . * . 4 2 - . 0 1 - . 0 5 * - . 4 1 - . 0 5 . 2 0 - . 2 4 - . 2 5 . 5 0 8 . T o p u r s u e a p a t h o f i n t e l l e c -t u a l c u r i o s i t y . * . 7 1 . 0 8 - . 0 1 - . 0 8 . 1 2 . 1 8 - . 0 4 - . 0 6 . 5 8 9 . T o e x c h a n g e i d e a s a n d i n f o r -m a t i o n . . 3 1 - . 0 8 - . 0 3 - . 1 1 - . 0 2 * . 6 9 . 0 4 - . 1 7 . 6 2 00 A p p e n d i x D ( C o n t i n u e d ) L e a r n i n g O r i e n t a t i o n I n d e x I t e m V a r i a b l e s F a c t o r s C o m m u n a l i t y I I I I I I I V V V I V I I V I I I 1 0 . T o a s s o c i a t e w i t h o t h e r o f s i m i l a r i n t e r e s t s . . 1 5 - . 3 5 . 0 1 - . 0 5 . 0 2 * . 4 7 . 0 4 . 0 3 . 3 7 1 1 . T o e n j o y t h e s a t i s f a c t i o n t h a t c o m e s f r o m l e a r n i n g . * . 6 6 - . 0 6 . 1 4 - . 0 9 . 0 8 . 3 3 . 0 3 - . 0 6 . 5 9 1 2 . T o f u l f i l l a n e e d f o r p e r s o n a l a s s o c i a t i o n s a n d f r i e n d s h i p s . . 0 2 * . 7 5 . 0 9 - . 0 5 . 0 2 . 1 4 - . 1 5 - . 0 8 . 6 2 1 3 . T o c o m p e n s a t e f o r u n f a v o u r a b l e a c c e p t a n c e b y a s s o c i a t e s . - . 0 6 - . 2 0 . 2 6 - . 1 9 - . 0 1 - . 0 2 - . 3 3 - . 0 3 . 2 5 1 4 . T o i n t r o d u c e m e t o n e w i d e a s w h i c h I c a n f u r t h e r e x p l o r e o n m y o w n . * . 4 7 . 0 1 . 1 7 - . 1 7 - . 0 2 . 2 6 . 0 0 - . 2 4 . 4 1 1 5 . T o f i l l a n e c o n o m i c m o t i -v a t i o n . . 0 2 - . 2 1 * . 5 9 - . 1 0 - . 0 0 . 0 5 - . 0 9 - . 0 9 . 4 2 1 6 . T o f i l l a n i n n a t e y e a r n i n g f o r k n o w l e d g e . * . 7 7 . 0 6 . 1 2 - . 0 3 - . 0 6 . 1 2 - . 0 8 - . 1 7 . 6 7 1 7 . T o u n d e r t a k e g r o u p p a r t i c i -p a t i o n a s a s o c i a l l y a c c e p t a b l e c h a n g e f r o m i s o l a t e d i n d i v i d u a l s t u d y . . 0 4 - . 2 1 . 1 5 - . 0 3 - . 2 0 * . 4 3 - . 2 9 - . 0 7 . 3 9 1 8 . T o g a i n r e c o g n i t i o n a m o n g p e e r s . - . 0 5 - . 2 7 * . 6 2 - . 1 2 - . 0 1 . 1 1 - . 1 7 - . 0 2 . 5 1 A p p e n d i x D ( C o n t i n u e d ) L e a r n i n g O r i e n t a t i o n I n d e x I t e m V a r i a b l e s F a c t o r s C o m m u n a l i t y I I I I I I I V V V I V I I V I I I 1 9 . T o s e e k r e l i e f f r o m b o r e d o m . - . 0 2 - . 2 5 . 1 5 • 1 7 . 0 2 - . 0 6 * - . 6 7 - . 0 4 . 5 7 2 0 . T o f u r t h e r e x p o s e a n i n s a -t i a b l y c u r i o u s m i n d . * . 7 1 - . 0 3 . 0 9 . 0 6 - . 0 5 - . 0 7 - . 1 5 - . 2 7 . 6 2 2 1 . T o u n d e r s t a n d c o m m u n i t y p r o b l e m s . . 3 6 - . 0 4 - . 0 4 - . 2 6 - . 2 7 . 1 9 - . 1 0 * - . 4 5 . 5 2 2 2 . T o m a k e n e w f r i e n d s . . 0 1 * - . 7 1 . 1 9 - . 0 1 - . 0 0 - . 0 5 - . 2 2 - . 1 5 . 6 1 2 3 . T o s e c u r e p r o f e s s i o n a l a d v a n c e m e n t . . 1 3 - . 0 8 * . 6 5 - . 2 9 . 0 3 . 1 4 - . 1 1 - . 1 2 . 5 8 2 4 . T o g e t t h e s a t i s f a c t i o n o f a c c o m p l i s h m e n t . . 3 6 - . 2 1 . 1 2 - . 3 1 - . 0 6 . 0 8 - . 1 5 - . 0 8 . 3 2 2 5 . T o e x p e r i e n c e t h e p l e a s u r e o f m e e t i n g n e w p e o p l e . . 0 8 * - . 7 7 . 0 9 - . 0 6 - . 1 4 . 1 8 - . 0 1 - . 0 9 . 6 7 2 6 . T o d e s i r e e n l i g h t e n m e n t . * . 6 3 - . 2 5 . 0 5 - . 0 6 - . 1 9 . 0 1 . 1 5 - . 1 4 . 5 4 2 7 . T o s a t i s f y a d e s i r e t o b e a c t i v e . . 3 5 - . 2 9 . 0 1 - . 0 8 - . 1 6 . 0 6 - . 2 8 - . 3 9 . 4 7 2 8 . T o s a t i s f y i n t e l l e c t u a l c u r i o s i t y . * . 7 8 - . 0 5 . 0 2 - . 1 0 - . 0 3 . 1 0 - . 0 6 - . 2 6 . 7 0 2 9 . T o c l a r i f y w h a t I w i s h t o b e d o i n g 5 o r 1 0 y e a r s f r o m n o w . . 2 7 - . 0 7 * . 4 6 - . 1 5 - . 1 6 . 0 1 - . 0 5 - . 2 1 . 3 8 3 0 . T o s a t i s f y a n i n q u i r i n g m i n d . * . 7 2 - . 0 6 . - . 0 5 - . 1 5 - . 0 7 . 0 5 - . 0 2 - . 2 4 . 6 1 • £ A p p e n d i x D ( C o n t i n u e d ) L e a r n i n g O r i e n t a t i o n I n d e x I t e m V a r i a b l e s F a c t o r s C o m m u n a l i t y I I I I I I I V V V I V I I V I I I 3 1 . T o b e c o m e a m o r e e f f e c t i v e c i t i z e n . * . 4 3 . - . 2 1 - . 0 1 - . 1 5 * - . 4 6 . 0 1 . 0 2 - . 3 4 . 5 7 3 2 . T o b e c o m e a c q u a i n t e d w i t h c o n g e n i a l p e o p l e . . 2 0 * - . 7 1 . 0 9 - . 0 6 - . 1 9 . 0 0 - . 1 3 - . 0 5 . 6 1 3 3 . T o e n j o y t h e p l e a s u r e o f d i s c o u r s e . . 2 8 - . 3 9 . 0 3 . 0 7 - . 2 2 . 2 2 . 0 3 - . 2 0 . 3 7 3 4 . T o i n c r e a s e c o m p e t e n c e i n e m p l o y m e n t . . 3 0 - . 0 5 . 2 9 * - . 6 1 - . 0 9 . 0 7 . 1 4 . 0 4 . 5 7 3 5 . T o s t u d y f o r i t s o w n s a k e . * . 5 9 - . 1 0 . 2 1 . 1 3 - . 0 6 - . 0 7 - . 0 5 - . 1 6 . 4 6 3 6 . T o o v e r c o m e t h e f r u s t r a t i o n o f d a y - t o - d a y l i v i n g . . 2 1 - . 2 2 . 2 2 . 0 5 - . 1 4 . 0 9 * - . 5 5 - . 0 5 . 4 8 3 7 . T o f i n d i n t e l l e c t u a l e n r i c h -m e n t a n d s t i m u l a t i o n . * . 7 4 - . 0 7 . 0 4 - . 1 2 - . 0 6 . 1 7 . 0 0 - . 0 6 . 6 0 3 8 . T o l e a r n b e t t e r w a y s o f d o i n g t h i n g s . . 3 9 . 0 2 . 1 1 * - . 4 3 - . 2 3 . 2 2 . 0 7 . 0 4 . 4 5 3 9 . T o e n g a g e i n t h e d i s c u s s i o n o f i d e a s . . 3 3 - . 1 9 . 0 6 - . 1 4 - . 2 1 * . 6 7 . 0 1 - . 1 3 . 6 7 4 0 . T o b e l i e v e t h a t t h e a c t i v i t y p r o v i d e s r e s p e c t a b i l i t y . - . 0 1 - . 1 9 . 2 8 - . 0 0 * - . 5 5 . 1 3 - . 2 3 . 1 1 . 5 0 4 1 . T o s e e k t o c o n t r i b u t e t o t h e " c o m m o n g o o d " . . 1 9 - . 1 4 . 0 9 - . 1 5 * - . 1 6 6 . 0 5 . 0 4 - . 1 3 . 5 4 M i—• A p p e n d i x D ( C o n t i n u e d ) L e a r n i n g O r i e n t a t i o n I n d e x I t e m V a r i a b l e s F a c t o r s C o m m u n a l i t y I I I I I I I V V V I V I I V I I I 4 2 . T o f e e l a s o c i a l n e e d t o b e p a r t o f a n a c c e p t e d g r o u p . - . 0 4 * - . 4 4 * . 4 0 - . 0 2 * . 4 7 . 0 7 - . 3 1 . 0 6 . 6 7 4 3 . T o s a t i s f y a d e e p c u r i o s i t y a b o u t l i f e a n d i d e a s . * . 6 1 - . 2 5 . 0 0 - . 2 2 - . 1 7 - . 0 3 - . 1 9 - . 2 3 . 5 9 4 4 . T o d e v e l o p u n d e r s t a n d i n g . * . 4 0 - . 2 0 - . 0 5 * - . 5 6 - . 1 2 . 0 9 - . 1 5 - . 1 1 . 5 8 4 5 . T o u s e l e a r n i n g s i t u a t i o n s f o r s o c i a l p u r p o s e s . . 1 4 - . 3 9 . 2 5 - . 1 1 - . 0 8 . 0 6 * - . 4 4 - . 1 4 . 4 8 4 6 . T o d e s i r e t o l e a r n a n d t o k n o w . * . 7 3 - . 0 4 - . 0 3 - . 2 7 - . 1 0 . 0 9 - . 0 3 . 0 9 . 6 3 4 7 . T o p r e p a r e f o r s e r v i c e i n t h e c o m m u n i t y . . 2 3 - . 1 2 . 1 9 - . 2 8 - . 3 8 . 1 2 - . 1 3 - . 3 1 . 4 5 4 8 . T o p a r t i c i p a t e i n e d u c a t i o n a s a n e n d i n i t s e l f . * . 4 3 - . 1 2 . 3 3 . 1 4 - . 1 5 . 0 2 - . 1 2 . 0 2 . 3 7 4 9 . T o f e e l a n e e d t o b e a c c e p t e d b y o t h e r s . - . 0 2 * - . 4 3 * . 5 0 - . 0 1 - . 2 7 . 0 2 - . 3 9 . 1 7 . 6 9 5 0 . T o u n d e r t a k e e d u c a t i o n a s a m e a n s t o a n e n d . . 2 3 - . 2 2 * . 6 0 . 1 6 - . 0 1 . 0 0 . 0 0 . 0 2 . 4 9 5 1 . T o u n d e r t a k e a n a c t i v i t y w i t h a f r i e n d . - . 0 9 * . 6 2 . 1 7 . 0 2 - . 0 1 - . 0 7 - . 1 5 - . 0 3 . 4 5 5 2 . T o f e e l a n e e d f o r m o r e e d u c a t i o n . * . 6 2 - . 0 1 . 2 6 - . 2 7 - . 0 3 - . 0 3 . 0 1 . 1 6 • J J ho A p p e n d i x D ( C o n t i n u e d ) L e a r n i n g O r i e n t a t i o n I n d e x I t e m V a r i a b l e s F a c t o r s C o m m u n a l i t y I I I I I I I V V V I V I I V I I I 5 3 . T o e n j o y s o c i a l l y o r i e n t e d l e a r n i n g a c t i v i t e s . . 2 2 * - . 5 9 . 1 2 - . 0 5 - . 1 3 . 0 5 - . 1 2 - . 0 7 . 4 5 5 4 . T o e n j o y s e e k i n g k n o w l e d g e . * . 8 1 - . 0 4 . 0 1 - . 1 8 - . 0 7 . 0 5 - . 0 4 . 0 6 . 7 0 ' 5 5 . T o u s e e d u c a t i o n a s a m e a n s t o h i g h e r s t a t u s a n d p r e s t i g e . . 0 7 - . 1 8 * . 6 2 . 0 1 - • 1 9 - . 0 8 - . 2 0 . 0 2 . 5 1 5 6 . T o e n j o y t h e a s s o c i a t i o n w i t h o t h e r p e o p l e . . 0 3 * . 7 5 . 1 1 - . 1 4 - . 0 2 . 1 2 - . 1 1 . 0 1 . 6 3 5 7 . T o u p - g r a d e o c c u p a t i o n a l c o m p e t e n c y . . 3 1 - . 0 5 . 2 2 * - . 6 0 - . 0 5 . 0 8 . 1 8 - . 0 3 . 5 5 5 8 . T o e n j o y a c q u i r i n g m o r e k n o w l e d g e . * . 7 3 . 0 5 . 1 3 - . 1 9 - . 0 5 . 1 7 . 0 6 . 1 2 . 6 4 I t e m s i n c l u d e d i n e a c h f a c t o r a r e m a r k e d w i t h a n a s t e r i s k . A p p e n d i x E D i s t r i b u t i o n o f S c o r e s o n L e a r n i n g O r i e n t a t i o n I n d e x S t a t e m e n t s I t e m N u m b e r s a n d S t a t e m e n t s M e a n S . D , R a n g e 1 . T o r e t r a i n f o r v o c a t i o n a l c h a n g e s . 3 . 0 5 1 . 1 5 1 - 5 2 . T o b e w i t h f r i e n d s a n d a s s o c i a t e s . 2 . 7 9 . 9 9 1 - 5 3 . T o d e v e l o p c r e a t i v e e x p r e s s i o n ( a r t , m u s i c , d a n c e , s p e a k i n g , e t c . ) 3 . 4 4 . 9 6 1 - 5 4 . T o e n j o y i n d i v i d u a l l y o r i e n t e d a c t i v i t i e s , 3 . 5 8 . 8 7 1 - 5 5 . T o s a t i s f y a n i n n a t e n e e d f o r i n f o r m a t i o n a n d k n o w l e d g e . 4 . 0 6 . 7 6 1 - 5 6 . T o p a r t i c i p a t e i n a c t i v i t i e s t h a t a r e c o m p l e t e l y n e w t o m e . 3 . 7 7 . 8 7 1 - 5 7 . T o s e e k h e l p f u l i n s i g h t s a b o u t h u m a n r e l a t i o n s h i p s . 3 . 9 6 . 7 4 2 - 5 8 . T o p u r s u e a p a t h o f i n t e l l e c t u a l c u r i o s i t y . 3 . 9 1 . 7 5 2 - 5 9 . T o e x c h a n g e i d e a s a n d i n f o r m a t i o n . 3 . 9 6 . 7 7 2 - 5 1 0 . T o a s s o c i a t e w i t h o t h e r s o f s i m i l a r i n t e r e s t s . 3 . 8 0 . 8 1 1 - 5 1 1 . T o e n j o y t h e s a t i s f a c t i o n t h a t c o m e s f r o m l e a r n i n g . 4 . 1 6 . 7 4 2 - 5 1 2 . T o f u l f i l l a n e e d f o r p e r s o n a l a s s o c i a t i o n s a n d f r i e n d s h i p s . 3 . 2 1 . 9 4 1 - 5 1 3 . T o c o m p e n s a t e f o r u n f a v o u r a b l e a c c e p t a n c e b y a s s o c i a t e s . 1 . 9 1 . 7 9 1 - 5 A p p e n d i x E ( C o n t i n u e d ) I t e m N u m b e r s a n d S t a t e m e n t s M e a n S . D . R a n g e 1 4 . T o i n t r o d u c e m e t o n e w i d e a s w h i c h I c a n f u r t h e r e x p l o r e o n m y o w n . 1 5 . T o f i l l a n e c o n o m i c m o t i v a t i o n . 1 6 . T o f i l l a n i n n a t e y e a r n i n g f o r k n o w l e d g e . 1 7 . T o u n d e r t a k e g r o u p p a r t i c i p a t i o n a s a s o c i a l l y a c c e p t a b l e c h a n g e f r o m i s o l a t e d i n d i v i d u a l s t u d y . 1 8 . T o g a i n r e c o g n i t i o n a m o n g p e e r s . 1 9 . T o s e e k r e l i e f f r o m b o r e d o m . 2 0 . T o f u r t h e r e x p o s e a n i n s a t i a b l y c u r i o u s m i n d . 2 1 . T o u n d e r s t a n d c o m m u n i t y p r o b l e m s . 2 2 . T o m a k e n e w f r i e n d s . 2 3 . T o s e c u r e p r o f e s s i o n a l a d v a n c e m e n t . 2 4 . T o g e t t h e s a t i s f a c t i o n o f a c c o m p l i s h m e n t . 2 5 . T o e x p e r i e n c e t h e p l e a s u r e o f m e e t i n g n e w p e o p l e . 2 6 . T o d e s i r e e n l i g h t e n m e n t . 2 7 . T o s a t i s f y a d e s i r e t o b e a c t i v e . 2 8 . T o s a t i s f y i n t e l l e c t u a l c u r i o s i t y . 3 . 8 5 2 . 6 2 3 . 7 8 2 . 9 9 2 . 4 1 2 . 4 6 3 . 3 0 3 . 5 3 2 . 8 9 3 . 2 0 4 . 0 8 3 . 3 1 3 . 7 4 3 . 6 2 3 . 8 4 , 7 4 1 . 0 3 . 8 0 . 9 4 . 8 6 . 1 . 1 4 . 9 1 . 8 5 . 9 7 1 . 0 8 . 7 0 . 8 7 . 7 9 . 9 0 . 7 1 2 - 5 1 - 5 1 - 5 1 - 5 1 - 5 1 - 5 1 - 5 1 - 5 1 - 5 1 - 5 2 - 5 1 - 5 1 - 5 1 - 5 2 - 5 A p p e n d i x E ( C o n t i n u e d ) I t e m N u m b e r s a n d S t a t e m e n t s M e a n S . D . R a n g e 2 9 . T o c l a r i f y w h a t I w i s h t o b e d o i n g 5 o r 1 0 y e a r s f r o m n o w . 3 . 0 2 1 . 1 0 1 - 5 3 0 . T o s a t i s f y a n i n q u i r i n g m i n d . 3 . 7 6 . 7 0 1 - 5 3 1 . T o b e c o m e a m o r e e f f e c t i v e c i t i z e n . 3 . 4 0 . 8 8 1 - 5 3 2 . T o b e c o m e a c q u a i n t e d w i t h c o n g e n i a l p e o p l e . 3 . 0 9 . 9 0 1 - 5 3 3 . T o e n j o y t h e p l e a s u r e o f d i s c o u r s e . 3 . 1 3 . 9 2 1 - 5 3 4 . T o i n c r e a s e c o m p e t e n c e i n e m p l o y m e n t . 4 . 1 0 , 8 1 1 - 5 3 5 . T o s t u d y f o r i t s o w n s a k e , 3 . 0 2 1 . 0 5 1 - 5 3 6 . T o o v e r c o m e t h e f r u s t r a t i o n o f d a y - t o - d a y l i v i n g . 2 . 7 2 1 , 1 1 1 - 5 3 7 . T o f i n d i n t e l l e c t u a l e n r i c h m e n t a n d s t i m u l a t i o n . 3 . 7 7 . 7 8 1 - 5 3 8 . T o l e a r n b e t t e r w a y s o f d o i n g t h i n g s . 4 . 2 4 . 5 8 3 - 5 3 9 . T o e n g a g e i n t h e d i s c u s s i o n o f i d e a s . 3 . 7 9 . 8 0 1 - 5 4 0 . T o b e l i e v e t h a t t h e a c t i v i t y p r o v i d e s r e s p e c t a b i l i t y . 2 . 4 6 . 9 6 1 - 5 4 1 . T o s e e k t o c o n t r i b u t e t o t h e " c o m m o n g o o d " . 3 . 1 8 . 9 4 1 - 5 4 2 . T o f e e l a s o c i a l n e e d t o b e p a r t o f a n a c c e p t e d g r o u p . 2 . 4 7 . 9 2 1 - 5 A p p e n d i x E ( C o n t i n u e d ) I t e m N u m b e r s a n d S t a t e m e n t s M e a n S . D . R a n g e 4 3 . T o s a t i s f y a d e e p c u r i o s i t y a b o u t l i f e a n d i d e a s . 3 . 5 0 . 8 4 1 - 5 4 4 . T o d e v e l o p u n d e r s t a n d i n g . 4 . 0 1 . 7 3 1 - 5 4 5 . T o u s e l e a r n i n g s i t u a t i o n s f o r s o c i a l p u r p o s e s . 2 . 5 8 1 . 0 4 1 - 5 4 6 . T o d e s i r e t o l e a r n a n d t o k n o w . 4 . 0 2 . 6 7 2 - 5 4 7 . T o p r e p a r e f o r s e r v i c e i n t h e c o m m u n i t y . 3 . 0 5 . 9 7 1 - 5 4 8 . T o p a r t i c i p a t e i n e d u c a t i o n a s a n e n d i n i t s e l f . 2 . 7 3 1 . 0 5 1 - 5 4 9 . T o f e e l a n e e d t o b e a c c e p t e d b y o t h e r s . 2 . 4 6 . 9 2 1 - 5 5 0 . T o u n d e r t a k e e d u c a t i o n a s m e a n s t o a n e n d . 2 . 6 6 1 . 0 3 1 - 5 5 1 . T o u n d e r t a k e a n a c t i v i t y w i t h a f r i e n d . 2 . 6 8 . 9 4 1 - 5 5 2 . T o f e e l a n e e d f o r m o r e e d u c a t i o n . 3 . 7 6 . 7 6 1 - 5 5 3 . T o e n j o y s o c i a l l y o r i e n t e d l e a r n i n g a c t i v i t i e s . 3 . 0 3 . 8 5 1 - 5 5 4 . T o e n j o y s e e k i n g k n o w l e d g e . 3 . 7 9 . 7 4 2 ^ 5 5 5 . T o u s e e d u c a t i o n a s a m e a n s t o h i g h e r s t a t u s a n d p r e s t i g e . 2 . 3 6 . 9 7 1 - 5 5 6 . T o e n j o y t h e a s s o c i a t i o n w i t h o t h e r p e o p l e . 3 . 2 9 . 8 6 1 - 5 5 7 . T o u p - g r a d e o c c u p a t i o n a l c o m p e t e n c y . 4 . 0 7 . 7 6 2 - 5 5 8 . T o e n j o y a c q u i r i n g m o r e k n o w l e d g e . 3 . 9 6 . 7 1 2 - 5 

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