Professional values and attitudes

http://hee.nhs.uk/wp-content/blogs.dir/321/files/2014/10/VBR-Framework.pdf

I have now begun a bit of work comparing the first year and final year responses to the professional values exercise  (I have so far analysed 10 presentations in each year, representing the work of around 70 students. I am about 1/3 of the way through) and there are some interesting differences emerging.

It appears for instance that the mentions of Social Justice are considerably more frequent in the final year students' work than in that of the first years' - 61 mentions in this category as opposed to 26. The other categories are noticeably more evenly balanced, although the "attitudes" section gets around 50% more mentions overall amongst the final year students.

For the final year students, the order in which categories feature is: social justice, attitudes of the care giver, skills of the care giver, outcomes for the service user, management and teamwork. The first years' focus, in order, is on skills then attitudes of the care giver, followed by the outcomes for the service user, social justice and finally management and teamwork.

The most frequently mentioned values out of all the categories in the first year are (in order of number of times referred to) Equality and Diversity, Respect, Supportiveness, Teamwork and Relationships. For the final year students these are: Equality and Diversity, Respect, Person Centredness, respecting the service user's  individuality and Empowerment. Although Equality and Diversity are top in each year, this aspect is mentioned twice as many times by the final year students as it is by the first years.

In terms of the care giver's personal attitudes, the top five in each year are remarkably similar :
Respectful, Compassionate, Enthusiastic and Committed and Approachable, are in the top five for each year. The final year students then have Genuineness and Honesty whilst the first years have Supportiveness.

There were however some interesting issues raised by the first year students which did not appear on the final year students' agenda at all. An awareness of isolation and loneliness, particularly amongst the elderly, and of the need for service users (again mainly the elderly) to be cared for within their own communities, stood out for me. The other main difference is that the first year students seem to emphasise the building of a trusting and supportive relationship where the care giver is enriching lives whilst final year students celebrate the individuality of the service user, aim to empower them and encourage independence whist identifying the care giver's most important qualities as empathy, committment and genuineness.

So how do these emerging attitudes and values compare with what health and social care organisations require of their staff? The link below explains the NHS' Values Based Recruitment programme:
http://hee.nhs.uk/wp-content/blogs.dir/321/files/2014/10/VBR-Framework.pdf with its emphasis on compassion, respect and dignity and improving lives.

Here also is BASWs values and ethics code http://cdn.basw.co.uk/upload/basw_112315-7.pdf focusing on human rights and social justice.

There is a greater overlap between the BASW values and the final year students' whilst the NHS values are wholly embraced by both years. Those BASW values which appear very little in either groups' work are the more political goals of redistribution of resources and working in solidarity.

One way of looking at the students' values statements is to assume they reflect their growing knowledge and experience and in particular their developing understanding of professional practice and the evidence base for effective interventions.

They may, for example, represent the difference between an understandable naivety (in a good sense) on the part of the first year students who, lacking both work experience and knowledge base, enter the course with an as yet undefined urge to help, care for and support others. This was noticeable in an unembarrassed use of the words love and passion in some groups' work as well as the expression of a desire to serve others and to make a change in the world. 

After three years of study, having had opportunities to work in the health and social care field, and with a more nuanced understanding of the needs of service users, values around empowerment, personal responsibility, advocacy and removing stigma are foregrounded by final year students.

Another interpretation is that the values expressed echo the social and psychological stage of the students themselves - from a more dependent, relationship-based perspective which perhaps reflects the first year student's need for belonging, to a more self-confident, independent and individual identity, which mirrors the final year undergraduate's readiness to "fly the nest" and embark on their career. Obvioulsy that is a bit of a generalisation especially as we have a number of mature students with existing health and social care careers behind them - but it's certainly worth considering.

Clearly there is more to be done - firstly to finish the analysis to see if the differences really are as marked as they currently appear and then perhaps to follow up on this through further dialogue with the students themselves and a review of their final reflective assessments.