Successful disputation by Ms. Katrin Arianta: Staying and leaving intentions of prospective nurses

The Institute of Vocational Education and Training and in particular the Department of Vocational and Business Education congratulate Ms. Katrin Arianta (soon to be Dr. Katrin Arianta) on the successful defense of her dissertation entitled "The social-interactive learning process of the development of nursing professional aspirations in the initial phase of nursing training in the confrontation with intentions to stay and exit: A qualitative longitudinal study" on 23.09.2024.

Highlights of the dissertation:

• Qualitative longitudinal study in the first year of training of nursing professionals
• Development of a model to explain the intentions of nursing students to stay and leave the profession
• Identification of four prototypical trajectories of nursing career aspirations
• Empirical evidence that, among other things, the social context of the training and the opportunities for professional development (i.e. learning on the job) have a high influence on the development of intentions to stay and leave the profession

Here is a short summary of the dissertation in German and English:

German: According to forecasts, there will be a shortage of around 13 million nurses worldwide in the coming years (ICN, 2022), which is why retaining young talent in the nursing sector is becoming increasingly important. At the same time, despite an increase in contract terminations and dropout tendencies in nursing training (BMFSFJ, 2022; Destatis, 2023; Merkley, 2016), little is known about the development of exit and retention plans of nursing trainees (González & Peters, 2021). This study addresses this research gap by empirically investigating the development of nursing students' career aspirations (i.e. their zone of acceptable career alternatives in nursing; Gottfredson, 2005). The focus is on the first year of training, as premature contract terminations are more frequent during this period (e.g. BIBB, 2023; Holtmann & Solga, 2021; Uhly, 2021) and this phase is seen as a critical transition into the profession (Welzer, 1993).

In order to trace the developmental dynamics of nursing career aspirations from the subject perspective, a qualitative longitudinal study was conducted based on the grounded theory methodology (Corbin & Strauss, 2015). Using problem-centered interviews (Witzel & Reiter, 2012), 12 nursing trainees were interviewed at two to four points in time during their first year of training (total k = 35 interviews). In a theoretical sampling procedure, seven highly contrasting cases(k = 21 interviews) were selected for further analysis using grounded theory coding methods (Corbin & Strauss, 2015; Tiefel, 2005). A first result of this analysis was the conception of a model that can be used to explain the development of professional aspirations, taking into account social-interactive influences in the workplace, career-relevant needs and learning activities. This model was then used to identify development patterns of vocational aspirations during the first year of training. For this process analysis, a qualitative, longitudinal analysis procedure was developed based on the recommendations of Dreier et al. (2018) and the methodology of grounded theory (Corbin & Strauss, 2015). This made it possible to optimize the initial model with regard to process phenomena on the one hand and to identify typical process variants on the other.

The process analyses show various influences of interactions with those involved in training (e.g. colleagues, trainers) on the vocational aspirations of the trainees and the associated intentions to leave and/or stay. The experience of the relationship with them and the social and professional integration experienced in the practical field have a particular impact here. The resulting dynamics can be typified in four process variants: (a) The arrival and intention to stay, in which the social environment is experienced positively and the intention to stay is motivated by the feeling of being or becoming a fully-fledged member of the community; (b) The intention to stay, in which the social environment is experienced positively and the intention to stay is motivated by the feeling of being or becoming a fully-fledged member of the community. (b) the intention to stay as a transitional passage, whereby staying is seen as a temporary transition from the start of training and negative social experiences are responded to with a perseverance strategy; (c) the search to stay, whereby opportunities are sought to avoid having to leave the nursing profession despite negative interaction experiences in the field of practice; (d) the exit as a short circuit, whereby individual negative interaction experiences trigger an exit plan.

The results indicate a very dynamic development of professional aspirations in the first year of training, which is strongly dependent on the subjective experience of the nursing field of work and the social interactions within it and is therefore difficult to predict. The development of professional aspirations is therefore a partly random process, as Krumboltz (2009) also points out. In addition, the study provides evidence that a dropout does not necessarily have to be preceded by an accumulation of negative experiences, as previously assumed in many research studies on the dropout process (e.g. Deuer, 2016, 2003; Heublein & Wolter, 2011; Krötz & Deutscher, 2022).

English: Forecasts predict a shortage of about 13 million nurses worldwide in the coming years (ICN, 2022). As a result, retaining young nurses within the profession has become critically important. Unfortunately, despite increasing dropout rates in nursing education (e.g., BMFSFJ, 2022; Destatis, 2023; Merkley, 2016), little is known about the factors that contribute to either retention or dropout intentions in nursing training (Garcia González & Peters, 2021). To address this research gap, this thesis explores how nurses' vocational aspirations (i.e., their range of acceptable career alternatives in the nursing field, e.g., Gottfredson, 2005) evolve during the early stages of their training. The present study focuses on the first year of training, as dropouts are more frequent during this period (e.g., BIBB, 2023; Holtmann & Solga, 2021; Uhly, 2021). This phase is regarded as a critical transition into the profession (Welzer, 1993).
To understand the dynamics of how nursing students' vocational aspirations evolve during their first year of vocational training, a qualitative longitudinal research study based on grounded theory was conducted. A total of 12 students were interviewed at two to four measurement points during their first year of their training(k = 35) using a problem-centered interview approach (Witzel & Reiter, 2012). Through theoretical sampling (Corbin & Strauss, 2015), seven highly contrasting cases were selected for in-depth analysis. In a second step, the 21 interviews from these cases were analyzed to develop a model that includes workplace factors, career-related needs, and learning activities to explain changes in vocational aspirations. In a third step, this model was used to identify distinct patterns of how vocational aspirations shift over time. To analyze this process, a qualitative longitudinal analysis method was developed, drawing on the recommendations of Dreier et al. (2018) and grounded theory methodology (Corbin & Strauss, 2015).

The analyses indicate that most students experienced fluctuating thoughts about persistence and withdrawal during the first months of their nursing training. Social interactions, particularly at the workplace with colleagues and trainers, appear to strongly influence whether students consider dropping out or continuing in the profession. Key factors in the (re-)construction of vocational aspirations include how students perceive their relationships with experienced nurses and the degree to which they are integrated into the existing community of practice. In this context, the contrast between hostile or aggressive behavior exhibited and kindness, both by more experienced nurses, is particularly significant. The development of vocational aspirations among the interviewed students can be categorized into four distinct process patterns: (a) "Arriving and wanting to stay" referring to a scenario where the social environment is experienced positively, and the intention to stay is shaped by the feeling of being or becoming a full member of the community; (b) "Staying as a transitional passage" occurs when from the outset of the training, remaining in the profession is seen as a temporary transition, with negative social experiences managed through a strategy of perseverance; (c) "Seeking to stay" involves looking for ways to remain in the nursing profession despite negative interaction experiences in the practical field; and (d) "Exit as a knee-jerk reaction", which describes how single negative interaction experiences can trigger an immediate plan to leave the profession.

The longitudinal perspective employed in this study reveals that students' retention and dropout intentions evolve in highly dynamic ways during their first year of nursing training. Moreover, distinct patterns suggest that this development is highly heterogeneous, influenced by the specific experiences students encounter in their workplaces. Accordingly, the development of vocational aspirations is partly a phenomenon affected by chance, as Krumboltz (2009) also asserts. In particular, social interactions with various work-related stakeholders appear to significantly shape how vocational aspirations shift during time. This provides evidence that dropout intentions are not necessarily based on an accumulation of negative experience as suggested in the literature (e.g., Deuer, 2016; Heublein & Wolter, 2011; Krötz & Deutscher, 2022).