Art & science professional issues

Emotional intelligence and its role in recruitment of nursing students Lyon SR et al (2013) Emotional intelligence and its role in recruitment of nursing students. Nursing Standard. 27, 40, 41-46. Date of submission: January 7 2013; date of acceptance: March 1 2013.

Abstract This article considers the concept of emotional intelligence and how it can be used in the recruitment and development of nursing students. The links between emotional intelligence and the qualities of compassion and caring are examined. The ethical difficulties surrounding the use of emotional intelligence tests are explored and the value of using a variety of recruitment methods is emphasised. The article suggests that emotional intelligence is an ability which may be developed through nurse education programmes, even if not fully present at interview. The contribution of service users to the recruitment of nursing students is examined, suggesting that they offer some important observations about interviewees. These observations may be more valid than the insights gained from the use of emotional intelligence tests.

Authors Steven Robert Lyon and Fiona Trotter, senior lecturers Barrie Holt, Elaine Powell and Andrew Roe, associate lecturers All at University of Huddersfield, Huddersfield Correspondence to: [email protected]

Keywords Compassion, emotional intelligence, empathy, recruitment, selection

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CritiCism of nursing standards has come from patients (Patients Association 2012), the press (Patterson 2012), politicians (Clywd 2012) and the nursing profession itself (Jones 2010, Chaffer 2012, Dean 2012, Wetherall 2012). in response, England’s chief nursing officer has introduced a three-year compassion in practice strategy (Department of Health (DH) 2012) in an attempt to ensure that nurses are caring, compassionate, competent, communicative, courageous and committed (the 6Cs) – all qualities associated with being an emotionally intelligent nurse. the critics mentioned above suggest that the nursing profession values intellect above compassion and that this is the reason why older people, in particular, receive poor care. recruitment of nurses has emphasised qualifications rather than selecting people with values underpinning the 6Cs. generally people value a compassionate attitude, and patients value personal attitudes as well as technical competence (Playle and Bee 2009, repper and Perkins 2009). nurse recruitment processes need to improve the chances of selecting people who are likely to be caring and compassionate (DH 2012). However, what the critics fail to appreciate is that selection processes are not as precise as they would like to believe. this article examines the selection process and the possibility of identifying nursing recruits who are high in emotional intelligence – people who will use their empathy to benefit patients. this article describes the challenges involved in interviewing and selecting nursing candidates with the ‘right’ qualities and explores some of the solutions. the concept of emotional intelligence and how it can be tested is also discussed. A variety of selection methods including the use of service users as a key part of the recruitment process are examined.

Emotional intelligence Emotional intelligence and its importance in nursing has been emphasised increasingly over

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Art & science professional issues the last few years (freshwater and stickley 2004, montes-Berges and Augusto 2007). Emotional intelligence has been defined as the ability to perceive, understand, and use emotion effectively (salovey and mayer 1990). freshwater and stickley (2004) discussed the role of emotions in caring for patients and how emotional intelligence allows nurses to be more reflective in their practice. similarly, montes-Berges and Augusto (2007) explored the importance of emotional intelligence in caring relationships and how it enables nurses to manage the stress involved in caring for others more effectively. Emotional intelligence has been described as an ability (salovey and mayer 1990) and as a trait (goleman 1995, Bar-on 1997). the ability model of emotional intelligence suggests that it consists of a set of related skills including the ability to recognise our emotions and those of others, and the ability to use and manage emotion. in contrast, the trait model suggests that it is a predisposition, an underlying quality to get on with people through the judicious use of emotion. Both models have strengths and limitations. the ability model suggests that emotional intelligence can be developed. if we believe that nursing recruits have an average ability for this then their emotional intelligence can be enhanced with appropriate training (Williams and stickley 2010, Cunico et al 2012, Lapum et al 2012). freshwater (2004) suggested that emotional intelligence requires self-awareness that results in emotional fluency (literacy) and that training is the key to this development. she suggested that what is required is ‘emotionally literate training’ and that it is essential to involve service users in this process. freshwater (2004) did not advocate the use of emotional intelligence tests during selection processes, but rather the provision of learning experiences that allow nurses to develop an ability to become aware of the feelings of patients. this perspective acknowledges that emotional intelligence is not fixed for life and can be enhanced under the right conditions. However, the trait model of emotional intelligence also has its appeal; if people have a predisposition to emotional intelligence and are tested accurately for this, then we should be able to predict who the emotionally intelligent nurses might be. this perspective asserts that emotional intelligence is an enduring quality that, if present, will always exist. However, the opposite may also be true and applicants for nursing may be excluded

if the view is that their innate capacity for emotional intelligence is limited. Conversely, the ability model suggests that even if at the time of recruitment the person has limited emotional intelligence, this can be developed with appropriate training. Compassion has been described as an essential part of nursing and its links with emotional intelligence have been noted (Heffernan et al 2010). the same authors also suggested that without compassion, nurses will fail to notice and respond to the suffering of others.

Emotional intelligence tests there are several emotional intelligence tests available, all of which have their critics. three are described here. the mayer-salovey-Caruso Emotional intelligence test (msCEit), which measures people’s ability to recognise as well as manage emotion in self and others (mayer et al 2002), is probably the most extensively researched test with studies examining its validity and reliability (maul 2012). Validity indicates that a test measures what it sets out to measure, while reliability is present if the same scores are achieved when the test is repeated. However, it is quite costly to administer and requires training to use. the Bar-on model of Emotional-social intelligence (Bar-on 1997) is a self-report test that has received some criticism because it is suggested that it is easy to provide false results (or responses) (tett et al 2012). if people know that they are going to be rejected if they have low emotional intelligence, then they are likely to try to alter their scores to achieve a higher score. this test considers motivation and perseverance, mood management and interpersonal aspects, and has been found to have some predictive validity regarding coping with emotions (mathews et al 2006). However, newsome et al (2000) and Pope et al (2012) have suggested that, despite previous claims, there is limited evidence that the test can predict future performance. this is similar to other tests where there is still limited evidence to be able to say with certainty that it can help predict future performance. there is also a charge for its use, which given the number of applicants, may limit its use. some emotional intelligence tests are free to use, such as the schutte self report Emotional intelligence test (schutte et al 1998). this test measures candidates’ ability to recognise their emotions and manage their mood and optimism. Austin et al (2004) and gignac et al (2005) suggested that the test may be able to identify

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candidates who are strong in some aspects of emotional intelligence but that it needed further development. this test has been in use at the university of Dundee, and rankin (2009) suggested that it is proving useful as a reliable predictor of nurses’ academic performance and in identifying those who are less likely to leave a nurse education programme. the use of emotional intelligence tests is controversial and support for such tests is weakened by the lack of correlation between them (furnham 2006). thus, if someone has a high score on one test he or she should have a high score on the others – and similarly if he or she has a low score on one then the same should be true on the others – but this validity has not been demonstrated. this suggests that one or more of these tests is testing for different things, for example personality or cognitive ability, which may not be emotional intelligence. such doubts raise concerns about the rigour and fairness of selection and recruitment processes involving emotional intelligence tests. Critics have also pointed out that emotional intelligence tests offer little more than is found in other personality tests, such as the Big five Personality test (mcCrae and John 1992), which have been around for longer and have been subjected to more validity and reliability tests (schulte et al 2004, fiori and Antonakis 2011, maul 2012).

Other ways of testing emotional intelligence the risks involved in using emotional intelligence tests may be lessened if they are used alongside other selection methods. tests that allow a candidate’s emotional intelligence to be observed directly can be set up. the use of patients or service users in interview situations brings a realistic dimension to the selection process. By asking appropriate questions, service users are often quick to identify which candidates have the qualities to create trust and engage with patients. simulated situations such as ‘talking with service users’ are used at the university of Huddersfield and have allowed student selectors to see how well existing students perform when communicating with service users. these simulated situations are set up as work stations where applicants converse with service users and it becomes apparent whether applicants have the basic interpersonal skills to engage with service users. At the university of Huddersfield, service users have been involved in the identification of assessment criteria and assessment tools for use

with nursing students and have trained other service users in their use. these assessment tools include a guide as to what to expect to see demonstrated by a nursing student in conversation with a patient. While attention has focused on emotional intelligence tests, this may have been at the expense of other more appropriate tests such as those that measure empathy. Empathy – combined with compassion – is one of the most important traits that a nurse should possess (reynolds and scott 2000). Empathy is a foundation skill that makes up most of what constitutes emotional intelligence (mcglade et al 2008). for example, the msCEit purports to measure the ability to recognise emotion in others and this ability is associated with empathy (mcglade et al 2008). Although not well researched nor without critics, there are tests that measure empathetic ability which, when combined with service users’ perception of candidates’ sensitivity, might be a better option than emotional intelligence tests (muncer and Ling 2006, Yu and Kirk 2008, 2009). tests for empathy become even more relevant when its effect on service users is considered. research has suggested that the establishment of an empathetic relationship has a physical effect on service users. for example, stress-associated hormones are reduced, and parts of the brain (such as the limbic system and the left prefrontal cortex) that motivate people to form positive relationships are stimulated (siegel 2012).

Importance of testing for empathetic ability on reviewing the literature, gibbons (2011) emphasised that empathy is a precondition for collaborative respectful relationships. she also suggested that people who receive empathy throughout their life are more resilient to stress than others and extend this benefit to their children (Hughes and Baylin 2012). nurses who are empathetic are more likely to have a history of healthy family and social attachments (siegel 2012), and this ability to form healthy attachments may then be extended to their work with patients (Allen et al 2008). While there are ethical and operational difficulties in examining applicants’ previous attachment histories, it may be easier to measure empathy, although it should be emphasised that people from a variety of backgrounds have the potential for developing empathetic ability. Empathy and other caring qualities may also be observed during group exercises in interviews. nurses require effective teamworking skills and

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Art & science professional issues these can be assessed in group exercises. the way in which candidates interact with each other, whether they refrain from talking over their peers, and whether they listen to and respect the views of others can all be observed during group activity. getting a group of nursing candidates together to prioritise particular nursing values can be revealing. Questions asked of a group can be focused so that certain preferences can be explored, such as whether group members rate control over care or whether they prefer ‘doing with’ as opposed to ‘doing to’. given this type of group exercise, a candidate’s unfavourable personal values can be picked up by interviewers, for example a tendency to be judgemental, prejudiced or disrespectful about others’ opinions. this can be captured using carefully designed forms that allow the applicants’ contributions to be scored. the nursing candidate’s selection interview should be comprehensive in order to ensure that the right people are selected. Despite the importance of selecting the right students, it can be difficult for nurse educators to argue a case for selection interviews of sufficient length. this is because universities scrutinise how staff spend their time and any work not labelled as teaching, assessment or research may be questioned (Harris 2012).

Service users and the selection process the value of service user involvement in recruiting future nurses cannot be over-emphasised (terry 2012a, 2012b). Educators may benefit from listening to service users’ views during the selection process. in the authors’ experience, nursing students evaluate the process of service user involvement positively. With training, service users can make a useful contribution to nurse education by working jointly with nurse educators to present seminars to nursing students based on personal experience. At the university of Huddersfield, service users from adult, learning disability and mental health settings have been involved in teaching appropriate subjects such as living with mental ill health and living with a disability. the authors suggest that service users should form an integral part of the recruitment team, and with the right preparation they can offer insights into applicants’ interpersonal abilities. the authors have found that service users have an ability to identify the presence or absence of desirable qualities. thus, service users may comment that a particular applicant was caring, compassionate or understanding because

of a phrase he or she used, a sensitive question asked or a particular non-verbal gesture. it makes sense then to include in the selection procedures a process for capturing service users’ perspectives of applicants.

Students’ experiences of service user involvement

At the university of Huddersfield, the authors have undertaken an evaluation of nursing students’ experiences of being assessed by service users. An anonymous questionnaire was distributed to 45 students and completed by 16 to capture their views about service users’ involvement in assessment processes. the authors were surprised by the strength of student opinion that rated service user feedback as high – higher in some cases – as that of the nurse educator. nursing students value the sensitive way in which service users provide feedback. Based on this feedback many students have become committed to personal development plans designed to enhance their empathy and compassion.

Future work this article highlights some of the challenges facing educators and clinicians involved in nursing student recruitment in getting the selection methods right. increasing the frequency and quality of service user input in selection procedures may be a positive development in this area. there may not be one test that can identify nursing recruits with an appropriate measure of emotional intelligence, and therefore it makes sense to use a variety of approaches. However, there is a need to have a national debate on successful processes for selecting and recruiting nursing students who will work in a caring and compassionate way. in the absence of national guidance, nursing students recruited in various parts of the country may not have similar qualities. simulated role play is a valuable opportunity to observe candidates but it has limitations. it is time-consuming and requires substantial resources in terms of people and time. moreover, it can induce anxiety in candidates. there is a need to research further how role play can be used in such a way that it allows the most appropriate candidates to be selected rather than those who are most able to manage their anxiety. research is also needed to examine the validity and reliability of the various available tests. insufficient research has been undertaken to demonstrate the predictive value of existing emotional intelligence tests and whether they are

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better than other tests of personality, which have established validity and reliability. research could also examine tests for empathy or other factors associated with the 6Cs, which could then be used with nursing candidates. several universities are showing an interest in a test that is being constructed by the university of Cambridge, the Cambridge student Personal styles Questionnaire, which aims to help screen inappropriate applicants. this is specific to recruiting nursing students and will attempt to measure critical and thinking styles, self-discipline and organisation, social responsibility, stress tolerance and emotional control, caring and helping. the solution may be not to measure emotional intelligence but rather to focus on recruiting people with caring and compassionate qualities that are valued by service users: concern for others and interest in people, both of which can be observed at interview. then at least recruits will have the ‘right foundations’ and with the right mix of educational support (Anderson and Burgess 2011), perhaps they can acquire those competencies that are required to become caring and compassionate nurses.

Conclusion in summary, some emotional intelligence tests offer some predictive value when used alongside other selection methods, but more research is required. Whichever tests are ultimately identified as appropriate, it is better to use a variety of methods rather than place faith in a single emotional intelligence test. regardless of the challenges posed, there is a need to employ recruitment processes that are valid and reliable, especially as patients expect such a lot from nursing staff and the selection process must reflect this. staff at the university of Huddersfield will continue to use, evaluate and review the schutte self report Emotional intelligence test. However, this may be replaced by the Cambridge student Personal styles Questionnaire, if appropriate, in addition to service user involvement in selection interviews, and exercises that help assess candidates’ motivation and qualities. this article has discussed the construct of emotional intelligence and the difficulties in defining and testing it. it is an area that is generating considerable interest, much of this because of its links with compassion and caring and the need to recruit

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Emotional intelligence and its role in recruitment of nursing students.

This article considers the concept of emotional intelligence and how it can be used in the recruitment and development of nursing students. The links ...
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