The public expects nurses to serve as change agents and patient advocates. The process of empowerment must start in nursing school. This article reports on a descriptive analysis of students' perceptions of empowerment conducted to identify a baseline level. The purpose was to assess such perceptions within the learning environment experienced by baccalaureate nursing students in traditional, prelicensure programs. The research question was: "What is the degree of structural empowerment within student nurses' learning environment?" In addition to age, gender, ethnicity, and semester in program, data were collected about previous health care experience and grade point average (GPA).

RELEVANCE AND BACKGROUND

Two decades of research support Kanter's theory of structural empowerment (1977, 1993) and its application in nurses' working environments, but there is little research regarding empowerment for nursing students. The academic venue is different from the work setting. This study is warranted because schools of nursing supply graduates to work settings.

Nurse educators are charged with preparing graduates who can function in a complicated health care environment. Interest for examining empowerment among nursing students stems from the belief that, if the learning environment engenders a sense of empowerment, the student is more likely to be successful as a graduate nurse.

The theory of structural empowerment began with study of the workplace. (1977, 1993) suggested that structural empowerment is connected to perceptions of access to information, resources, support, and opportunity as well as perceptions of formal and informal power. These "structural determinants" are modifiable within the work environment by organizational leaders who can influence change. Transferring this theory to the learning environment, faculty can create positive learning conditions.

Work by Laschinger and others (Armstrong & Laschinger, 2006; Faulkner & Laschinger, 2008; Laschinger, 2008; Laschinger, Finegan, Shaiman, & Casier, 2000) demonstrates positive, strong correlation between structural empowerment and several factors: job satisfaction, productivity, organizational commitment, quality of care, and feelings of respect. Subsequent research found that nurse faculty perceived themselves as moderately empowered. Significant, positive correlations between structural empowerment and innovative teaching behaviors were identified (Hebenstreit, 2012).

In nursing students, Siu, Laschinger, and Vingilis (2005) found that structural empowerment increases student motivation and confidence, promoting self-directed learning. Livsey (2009) found a direct relationship between structurally empowering clinical learning environments and self-reported professional nursing practice behaviors. Assessing students' perceptions of structural empowerment within their learning environment can inform academic educators of areas needing improvement.

METHOD

Instrument

Kanter's Conditions of Work Effectiveness Questionnaire (CWEQ) measures opportunity, access to information, support for the work, and access to resources. Contained within the CWEQ are the Job Activities Scale (formal power) and the Organizational Relationships Scale (informal power; Laschinger, Kutzscher, & Sabiston, 1993). The CWEQ has established validity and reliability and has been used in nursing populations for years (http://publish.uwo.ca/~hkl/research/programs/empowerment.html). It was adapted to students' learning environment and used to measure students' perceptions of empowerment (Siu et al., 2005).

The CLEQ is a 32-item instrument with six subscales, each rated on a 5-point Likert-type scale; scores range from 1 to 5, with higher scores representing stronger perceptions. Items in the CLEQ have undergone factor analysis, with retained items demonstrating factor loadings >.40. Cronbach's alpha reliability estimates for the CLEQ range from .87 to .91 (Siu et al., 2005).

Data Collection

Institutional review board approval was obtained. The study population was BSN students in accredited, traditional, prelicensure nursing programs in the United States. This population was chosen because: a) the Institute of Medicine (2011) recommends increasing the proportion of nurses with BSN degrees to 80 percent by 2020, b) the researchers believe that prelicensure students' learning environments might be the most malleable, and c) using one type of program leads to a reduction in confounding variables.

The American Association of Colleges of Nursing Commission on Collegiate Nursing Education's list of accredited programs was used to find participants. Information about the study was sent to potential participants only if program administrators agreed to let eligible students volunteer to participate. The link to the survey was passed to eligible students via their deans and faculty. Data were collected via SurveyMonkey. Completion of the survey served as consent to participate.

RESULTS

The convenience sample consisted of 203 participants from schools located in 17 different states who completed the CLEQ and demographic questions. Names of schools were not collected. No incentive was offered. This nonrepresentative sample is a study limitation.

Tennessee provided the largest group of students (26.7 percent), followed by Pennsylvania (20.7 percent) and Missouri (10.8 percent). The largest age group was between 21 and 29 years (69 percent), with 30 to 39 years old the second largest group (13 percent). Most participants were Caucasian (79 percent); 8 percent were African American. Most (90.6 percent) had a cumulative GPA of 3.1 and above. Participants were primarily third-, fifth-, and fourth-semester students; 71 percent had at least one year of health care experience outside of nursing school. Overall the sample demonstrated moderate perceptions of structural empowerment within the learning environment. Summed means were >3.0 (M = 3.65, SD = 0.632), which indicates that participants perceived at least "some" presence of the factor. Subscale results follow in descending order: Access to Information (M = 4.10, SD = .642); Access to Opportunity (M = 3.83, SD = .721); Access to Resources (M = 3.65, SD = .759); Access to Support (M = 3.64, SD = .765); Formal/Informal Power (M = 3.02, SD = .839). No conclusions about differences among groups are reported in this article.

DISCUSSION

One might assume that, as novices, students would not perceive much, if any, empowerment. A moderate degree of empowerment, however, was detected (M > 3.0). Despite this positive finding, there is room for improvement. Further study might illuminate aspects within the learning environment that could be manipulated to improve students' perceived empowerment. For example, does involvement via advisory boards or committees contribute to feelings of empowerment? Would tutoring offered by faculty facilitate access to support?

Strategies can take many shapes. Siu et al. (2005) highlighted several methods to empower learning. Helping students develop their own individualized learning plans could lead to increased opportunity. Being available to help students with their learning and directing them to resources such as those offered by the library can affect perceptions of access to resources. Challenging students to critique the effectiveness of their learning resources and providing timely feedback about their progress can influence access to information. Perhaps most importantly, strategies to increase access to support include having an open-door philosophy, taking time to listen to students' learning needs and ideas, recognizing students' learning skills and accomplishments, and encouraging students to assume roles and engage in learning activities that showcase their strengths. Another role for faculty is to advise students in finding the right work environment following graduation.

IMPLICATIONS FOR PRACTICE

It is important for employers of graduate nurses to understand the value of an empowering work environment. Nursing leaders in the practice environment should consider exploring graduates' perceptions of structural empowerment. An empowering work environment is believed to be associated with recruitment, retention, organizational commitment, work satisfaction, professional practice, and perceived quality of care. There is considerable Magnet(R) hospital evidence that suggests that this environment attracts and retains nurses (Laschinger, Finegan, & Wilk, 2009).

Nurse residency programs help ease the transition into full practice, providing critical mentoring and support during a vulnerable time in a nurse's career. A growing body of evidence favors the efficacy of residency and other nurse orientation programs. Participants have shown positive gains in clinical confidence and performance, demonstrating positive perceptions of their work environment as well as their own commitment to the organization (Ulrich et al., 2010).

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