Entrepreneurial profile among undergraduate nursing students

Abstract

Objective

To identify the entrepreneurial profile among undergraduate nursing students.

Methods

Cross-sectional study, developed in 2018, with a total of 239 nursing students from two Higher Education Institutions in Santa Catarina, Brazil. Data collection took place through a personal characterization questionnaire and a validated instrument on the evaluation of the entrepreneurial profile in the academic environment. Descriptive statistics were used for data analysis.

Results

There was a predominance of students aged up to 20 years old (38.9%), female (88.1%) and the first two years of the course (51%). Regarding the entrepreneurial profile, 155 (64.9%) students were classified at the higher level and 84 (35.1%) at the upper medium level. The domain “Energy and Commitment” obtained the best score (4.49±0.57) and “Ability to Take Moderate Risks”, the lowest average (3.71±0.56), but still above the median of the scale.

Conclusion

There is a concentration of high levels of entrepreneurship in the profile of undergraduate nursing students.

Job market; Entrepreneurship; Students, nursing; Education nursing

Resumo

Objetivo

Identificar o perfil empreendedor entre estudantes de graduação em enfermagem.

Métodos

Estudo transversal, desenvolvido em 2018, com 239 estudantes de enfermagem de duas Instituições de Ensino Superior de Santa Catarina, Brasil. A coleta de dados ocorreu por meio de questionário de caracterização pessoal e instrumento validado sobre avaliação do perfil empreendedor no meio acadêmico. Utilizou-se estatística descritiva para análise dos dados.

Resultados

Predominaram estudantes na faixa etária de até 20 anos (38,9%), do sexo feminino (88,1%) e dos dois primeiros anos do curso (51%). Em relação ao perfil empreendedor, 155 (64,9%) alunos foram classificados no nível superior e 84 (35,1%) no nível médio superior. O domínio “Energia e Comprometimento” obteve a melhor pontuação (4,49±0,57) e “Capacidade de Assumir Riscos Moderados” a média mais baixa (3,71±0,56), mas ainda acima da mediana da escala.

Conclusão

Há concentração de níveis elevados de empreendedorismo no perfil de estudantes de graduação em enfermagem.

Mercado de trabalho; Contrato de risco; Estudantes de enfermagem; Educação em enfermagem

Resumen

Objetivo

Identificar el perfil emprendedor de estudiantes universitarios de enfermería.

Métodos

Estudio transversal, llevado a cabo en 2018 con 239 estudiantes de enfermería de dos instituciones de educación superior del estado de Santa Catarina, Brasil. La recopilación de datos se realizó mediante un cuestionario de caracterización personal y un instrumento validado sobre evaluación del perfil emprendedor en el medio académico. Se utilizó la estadística descriptiva para el análisis de los datos.

Resultados

Predominaron estudiantes del grupo de edad hasta 20 años (38,9 %), de sexo femenino (88,1 %) y de los dos primeros años de la carrera (51 %). Con relación al perfil emprendedor, 155 alumnos (64,9 %) fueron clasificados en el nivel superior y 84 (35,1 %) en el nivel intermedio superior. El dominio “Energía y compromiso” obtuvo la mejor puntuación (4,49±0,57) y “Capacidad de asumir riesgos moderados” el promedio más bajo (3,71±0,56), pero aún por arriba de la mediana de la escala.

Conclusión

Existe una concentración de niveles elevados de una tendencia emprendedora en el perfil de estudiantes universitarios de enfermería.

Mercado de trabajo; Contrato de riesgo; Estudiantes de enfermería; Educación en enfermería

Introduction

Globalization, the development of new technologies and social changes have demanded the training of professionals with a systemic view, capable of keeping up with this dynamism. In the health area, the need for nurses to be updated in the face of changes is increasingly perceived, which imposes the development of skills for insertion in the labor market and meeting the needs of society.(¹)The professional improvement of nurses must happen since graduation, aiming the formation of an entrepreneurial profile. This profile composes a critical spirit, proactivity, creativity, a willingness to innovate, a positive attitude and a capacity for negotiation. Thus, the ability to learn to know, learn to do, live and be.(²,³)

Entrepreneurship is generally conceptualized as the act of doing something new and different. This can occur within a market (business entrepreneurship), a company or organization (intrapreneurship) or for society (social entrepreneurship).(⁴)In Nursing, social entrepreneurship occurs when nurses act as agents of changes and transformations in health situation of patients and families in the community. Intrapreneurship refers to the role of nurses as agents of change and innovation in public and private organizations, in which they act as employees. Business entrepreneurship is characterized by the autonomous practice of nurses, such as in offices for the care of patients with wounds, home care, private care in obstetrics and maternal puerperium services.(⁵)

Therefore, in view of these typologies, it is understood that entrepreneurship is not only an important competence for the pursuit of autonomous practice, but a characteristic that enhances the performance of nurses in the management and care of people and communities.(⁵)Through entrepreneurship, nurses can, for example, develop innovations in the health care process, contributing to the recognition and social visibility of nursing work.(⁶)

Thus, the need for investment in scientific production on entrepreneurship in nursing is highlighted, especially regarding the entrepreneurial training of nursing students.(⁴,⁶) This was a gap evidenced in a literature review published in 2019 on entrepreneurship in nursing, which included international databases such as Publisher Medline (PUBMED), SciVerse Scopus (SCOPUS), and Cumulative Index to Nursing and Allied Health Literature (CINAHL).(⁴)

The training of nurses with transformative potential on a social, organizational and political level requires the presence of entrepreneurial skills in their academic profile. For this reason, studies on the entrepreneurial profile of students throughout their nursing training are important to leverage the vision of entrepreneurship in the profession and enhance the search for autonomy and professional qualification. In addition, research on this topic also contribute to the advancement and consolidation of Nursing Science. Given the above, the question was: what is the entrepreneurial profile of undergraduate nursing students?

Thus, the objective of this study was to identify the entrepreneurial profile among undergraduate nursing students.

Methods

This is a descriptive observational study. It was developed in two private Higher Education Institutions (HEIs), located in the state of Santa Catarina, Brazil. The nursing courses of both institutions have a duration of five years and happen at night. They have a similar pedagogical objective and organization, with a focus on training generalist nurses with technical and scientific skills to act in a reflexive, critical, creative, humanistic and transformative way. None of the courses includes specific subjects on entrepreneurship in the curriculum. However, the theme is addressed in disciplines related to professional practice, the labor market and/or management of health and nursing services.

The study population consisted of a total of 288 students enrolled in undergraduate nursing courses at HEIs. The sampling was non-probabilistic and for convenience, as it predicted the participation of the total population. The inclusion criterion was to be regularly enrolled in the Nursing Course. The exclusion criterion was to be absent at the time of data collection, due to a medical certificate or other leave of any kind. In total, 47 participants were excluded due to absence. Two students who were participating in the research project were also excluded. Thus, the sample was composed of 239 students, corresponding to 82.9% of the population.

Data collection took place during August 2018, through a self-administered questionnaire composed of questions of personal characterization (age, gender and year of the course) and the Entrepreneurial Profile Assessment Tool in Academic Environment, which was adapted of forms prepared by the Brazilian Micro and Small Business Support Service (SEBRAE) and validated for use by university students.(⁷) The research participants were approached in person by the research team during class and with the agreement of the coordination of the course and the professor responsible for the subject.

The Entrepreneurial Profile Assessment Tool in Academic Environment consists of 40 questions answered by students using a Likert scale with values from 1 to 5, ranging from “1=Totally Disagree” to “5=Totally Agree”. The questions are divided into eight domains/dimensions: Autonomy and Trust; Search for Opportunities and Vision; Ability to Take Moderate Risks; Ability to Innovate; Energy and Commitment; Leadership and Power Need; Obstinacy and Need for Achievement; and Systematic Planning.(⁷)

From the sum of each item, the respondents’ entrepreneurial profile is found. The closer the sum is to 200 (maximum score), the greater the presence of entrepreneurial attributes. Scores greater than 160 represent a superior entrepreneurial profile. From 121 to 160 points, the profile is considered to be upper medium. Between 81 and 120 points, the profile is medium. From 41 to 80 points, a lower medium profile is considered. Finally, results below 40 points indicate a lower entrepreneurial profile.(⁷)

The data were collected manually and transposed in a spreadsheet using the Excel® software. Data analysis was performed using descriptive statistics in the Statistical Package for Social Sciences (SPSS) software, version 20.0. Categorical variables were presented in the form of absolute frequencies (n), relative (%), and 95% confidence intervals for proportions. The age quantitative variable was categorized into age groups. The interval variables of the scale were expressed by measures of central tendency (mean and median) and dispersion (standard deviation, minimum and maximum).

The ethical aspects were respected, according to Resolution No. 466/2012 of the National Health Council. The project was approved by the reference Research Ethics Committee, with #2876878 and CAAE: 93974118.0.0000.5598.

Results

Of the total of 239 participants in the study, most were aged up to 20 years old (n=93; 38.9%) and female (n=208; 88.1%). As for the year of the course, just over half (n=122; 51.0%) of the students were enrolled in the initial years of the course, that is, in the 1st (n=61; 25.5%) and 2nd years (n=61; 25.5%) (Table 1).

Table 1
Demographic characterization and year of the undergraduate course of nursing students

Variable	n(%)	95%CI *
Age range (n=239)
Up to 20 years old	93(38.9)	32.7 – 45.4
21 to 25 years old	85(35.6)	29.5 – 42.0
26 to 30 years old	23(9.6)	6.2 – 14.1
31 to 35 years old	20(8.4)	5.2 – 12.6
Over 35 years old	18(7.5)	4.5 – 11.6
Gender (n=236)**
Female	208(88.1)	83.3 – 92.0
Male	28(11.9)	8.0 – 16.7
Course Year (n=239)
1st	61(25.5)	20.1 – 31.5
2nd	61(25.5)	20.1 – 31.5
3rd	44(18.4)	13.7 – 23.9
4th	33(13.8)	9.7 – 18.8
5th	40(16.8)	20.1 – 31.5

• *95% confidence interval for proportions. ** Less than the total sample, as three participants did not answer this question

Regarding the entrepreneurial profile, a total of155 (64.9%) students were classified at the higher level and 84 (35.1%) at the upper medium level. No student obtained a score for the lower, lower medium and medium levels. Among students classified at higher level, male students (71.4%), in the 3rd year of the course (68.2%) and in the age group of 30 to 35 years old (80%) predominated (Table 2).

Table 2
Higher and upper medium entrepreneurial profile according to gender, year of course and age group of nursing students

Variable	Higher	Upper Medium
	n(%)	n(%)
Gender (n=236)
Male	20(71.4)	8(28.6)
Female	132(63.5)	76(36.5)
Course year (n=239)
1st	40(65.6)	21(34.4)
2nd	39(63.9)	22(36.1)
3rd	30(68.2)	14(31.8)
4th	21(63.6)	12(36.4)
5th	25(62.5)	15(37.5)
Age range (n=239)
Up to 20 years old	54(58.1)	39(41.9)
21 to 25 years old	55(64.7)	30(35.3)
26 to 30 years old	16(69.6)	7(30.4)
31 to 35 years old	16(80)	4(20)
Over 35 years old	14(77.8)	4(22.2)

In the analysis of the dimensions of the entrepreneurial profile, the dimension “Energy and Commitment” obtained the highest/best score. The worst score was identified in the dimension “Ability to Take Moderate Risks” (Table 3).

Table 3
Analysis dimensions of the entrepreneurial profile of nursing students (n = 239)

Dimensions	Mean	Median	SD*	Minimum	Maximum
Autonomy and Trust	4.07	4.14	0.52	2.43	5.00
Search for Opportunities and Vision	4.29	4.33	0.69	1.33	6.00
Ability to Take Moderate Risks	3.71	3.71	0.56	2.00	5.00
Ability to Innovate	4.29	4.33	0.62	2.33	6.33
Energy and Commitment	4.49	4.66	0.57	2.33	5.33
Leadership and Power Need	3.93	4.00	0.58	2.17	5.83
Obstinacy and Need for Achievement	4.39	4.40	0.51	2.80	5.60
Systematic Planning	4.24	4.33	0.58	2.67	5.83

• *Standard derivation

Discussion

The analysis of the participants profile shows that insertion in higher education is occurring at an earlier age, at least in the context investigated, since most students were up to 20 years old (38.9%). This finding is in line with previous studies that showed the predominance of nursing students aged up to 25 years old.(⁸-¹¹)

In order to generate perspectives for growth and progress, the entry of young people in higher education can be considered a positive factor, reflecting an improvement in access to university education. On the other hand, the early option for the profession demands maturity from the students regarding the certainty of choosing a career. Thus, personal inexperience can make it difficult to face the real working conditions of nursing and compromise the development of skills related to entrepreneurship.(¹²)

As for gender, the predominance of women in nursing courses is already a widely described evidence in the literature.(⁷,¹⁰,¹¹,¹³)In addition, it reflects a historical characteristic of Nursing in a global scope that persists today, although gradually a greater insertion of men into the profession is observed.(¹¹,¹⁴)

As far as the entrepreneurial profile is concerned, the results obtained were positive as most students were classified in higher (64.9%) or upper medium (35.1%) level. No studies were identified in Nursing using the same instrument in order to compare the obtained indices. However, the findings of this study are similar to the results of research with students graduating from the International Trade course at a university in Rio Grande do Sul⁷ and dentistry students from a public university in Santa Catarina.(¹⁵)

Studies in Nursing using the General Entrepreneurial Tendency test (GET) found different results to those described in this research. According to this instrument, the entrepreneurial characteristics of nurses were below the general average.(¹⁶,¹⁷)Although they are distinct instruments, a similar aspect of GET with the instrument used in this study is that both have mastery over risk propensity, said as a characteristic of entrepreneurship; and that, in a correlated way to this research, it was the worst domain evaluated among nursing residents.(¹⁷)This may be related to the predominantly institutional characteristic of Nursing, which somehow contributes to the professional prioritizing insertion as a worker in a health organization or service, to the detriment, for example, of the search for an autonomous practice as an entrepreneur.

Entrepreneurship is a competence that can be influenced by psychological characteristics, social context, cultural and educational background, making it difficult to analyze these influences in a single study. Thus, the fact that in this research no student has obtained a low score for the entrepreneurial profile indicates a promising preparation in the professional career in nursing. On the other hand, it is prudent to assume that the fact that highly positive characteristics have been expressed in students’ self-perception does not guarantee entrepreneurial behavior in the future, because, as already stated, competence tends to be influenced by multiple factors, including social context and market dynamics.

Male students showed a higher concentration of the higher entrepreneur profile (71.4%) compared to female students in this same setting (63.5%). A study on entrepreneurial characteristics of nursing students in Turkey also showed a greater inclination of male students towards entrepreneurship. The research considers that this finding is related to the lower propensity of women to take risks, due to a cultural and socioeconomic context that stimulates male self-confidence and reinforces the maternal role and the domestic responsibilities of women.(¹⁸)Therefore, it is reaffirmed the social influence of this competence, even of values with stigmatizing potential.

Thus, it is worth noting the study findings on the challenges to the development of entrepreneurial actions by nurses in a leadership position in different health organizations and services in southern Brazil. Even though nursing is mainly performed by women, the nurses interviewed considered that they are affected by gender discrimination and difficulties in the creation and implementation of projects. In addition, they consider that their immediate leadership, in general, hinders the mobilization for entrepreneurship, endorsing a behavior that discredits the management capacity of women.(¹⁹)

3rd year students have a higher proportion in the higher entrepreneur profile (68.2%). This result may be associated with the students’ involvement in theoretical-practical activities in the middle of the course, which brings them closer to professional practice. In addition, it is a period marked by concerns regarding the insertion of the labor market among students, which can lead them to a greater dedication in the development of entrepreneurial characteristics such as leadership, communication and decision making. Similarly, an Australian study highlights the contribution of the students’ insertion in clinical settings to obtain a deeper view of their future professional role as a nurse.(²⁰)

The age group with prominence to the higher entrepreneur profile was 31 to 35 years old, followed by over 36 years old. This result suggests that people with more accumulated life experience stand out in terms of personal and professional skills linked to entrepreneurship.

A study with Brazilian nursing residents found that older students and professional experience showed more impulse and determination.(²¹)On the other hand, studies indicate the importance of personality traits for entrepreneurial inclination, with entrepreneurial characteristics predominating among younger people.(¹⁸,²²) Thus, the sooner the development of entrepreneurship education begins, the greater the students’ self-confidence, creativity and innovation potential.

Among the dimensions of the entrepreneurial profile of nursing students, the emphasis on “Energy and Commitment” can be associated with satisfaction and self-confidence resulting from the moment of academic learning and development. In addition, this result may be related to the increasing investment of nursing courses in the use of active methodologies, which encourage students’ involvement in their teaching process.(²³)

Another result that draws attention in relation to the dimensions of the entrepreneurial profile is the score for the “Leadership and Power Needs” domain, the second worst among the eight domains evaluated. A study carried out in Finland obtained similar results from the self-assessment of nursing students on the professional skills developed during undergraduate studies. Students consider themselves more competent to carry out activities of direct care to the patient than for managerial actions, related to planning, leadership and decision making.(²⁴)Thus, it is valid to point out the importance of discussions about the training of nurses, regarding the focus given to the development of competencies and skills for leadership and the political positioning related to the managerial dimension of nursing work.

It is important to point out that, although leadership permeates the managerial dimension of the nurses’ work, and, at the educational level, this is frequently linked to the area/discipline of Administration/Management in Nursing,(²⁵) it is believed that the development of entrepreneurship in general deserves transversality in the education of nurses. This is because it does not refer exclusively to technical-instrumental aspects of management or to the world/market/profession view. Entrepreneurial impulses are not limited to service or business management, they include nursing care in different production spaces.

The results of the study are limited in relation to the investigated context, as the research was developed only in higher education institutions through a convenience sample, without considering differences between phases and courses. In addition, the participants’ psychological characteristics, cultural aspects and motivation influence education in different ways, which cannot be controlled at the time of a survey. It is also necessary to consider that the instrument used to analyze entrepreneurship is not specific to the area of Nursing, that is, it does not cover the broad view of entrepreneurship for the profession, including the social one.

Despite these limitations, it is considered that the investigation brought satisfactory and important results, since the educational institutions surveyed will be able to know the results obtained and use them in the improvement of teaching, research and outreach policies with a focus on entrepreneurship. In addition, the research findings may support new studies aiming at theoretical advances in relation to the area investigated. Thus, the importance of qualitative studies or mixed methodology is emphasized to deepen and complement the description of the findings of this study.

Conclusion

The research evidenced the predominance of high levels of entrepreneurial characteristics in nursing students’ profile, especially among male participants, in the 3rd year of the course and in the age group of 30 to 35 years old. No student obtained a medium or low entrepreneurial profile. Although it does not guarantee entrepreneurial practices in the future professional practice, this reality can support directions that enhance the performance of nurses as a strategic transforming agent of reality and raise discussions about their social visibility.

Acknowledgements

Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil, process #424869/2018-7

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Publication Dates

• Publication in this collection
  26 Nov 2021
• Date of issue
  2021

History

• Received
  29 June 2020
• Accepted
  7 Dec 2020