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J Nurs Scholarsh. 2010 Sep 1;42(3):319-29. doi: 10.1111/j.1547-5069.2010.01358.x.

Measurement of students' perceptions of nursing as a career.

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Medical University of South Carolina, Charleston, SC 29425, USA.



Middle school has been identified as the prime age group to begin nursing recruitment efforts because students have malleable perceptions about nursing as a future career choice. The purpose of this integrative review is to present a brief overview of research processes related to middle school students' perceptions of nursing as a future career choice and to critically evaluate the current instruments used to measure middle and high school students' perceptions of nursing as a career choice.


An integrative review of the years 1989 to 2009 was conducted searching Cumulative Index to Nursing and Allied Health Literature (CINAHL), National Library of Medicine PubMed service (PubMed), and Ovid MEDLINE databases using the key words career, choice, future, ideal, nursing, and perception. Reference lists of retrieved studies were hand searched, yielding a total of 22 studies.


Inclusion criteria were (a) sample of middle school students, (b) sample of high school students, (c) mixed sample including middle or high school students, and (4) samples other than middle or high school students if the instrument was tested with middle or high school students in a separate study. Ten studies met these criteria.


Of the 10 studies, samples were 30% middle school students; 40% high school students; 10% mixed, including school-aged students; and 20% college students with an instrument tested in middle school students. Eighty percent of participants were White females. Overall, participants' socioeconomic status was not identified. A single study included a theoretical framework. Five instruments were identified and each could be completed in 15 to 30 min. The most commonly used instrument is available free of charge. Seventy percent of the studies used Cronbach's alpha to report instrument reliability (0.63 to 0.93), whereas 30% failed to report reliability. Fifty percent of the studies established validity via a "panel of experts," with three of those studies further describing the panel of experts.


Samples of white females may hinder generalization. Socioeconomic status was not consistently reported and may be an important factor with regard to perceptions of nursing as a career choice. An overall absence of theoretical framework hinders empirical data from being applied to nursing theories that in turn may support nursing concepts. The reporting of reliability and validity may be improved by further defining panel of experts and expanding the number of experts (more than seven). More in-depth evaluation of the psychometric properties of the instruments with more diverse populations is needed.


Rigorously tested instruments may be useful in determining middle school students' perceptions about nursing. Therefore, future researchers should consider testing existing instruments in the middle school population, adhering to theoretical frameworks, diversifying the sample population, and clearly reporting reliability and validity to gain knowledge about middle school students' perceptions about a nursing career.

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