Remote education during the COVID-19 pandemic and the level of interpersonal competences among nursing students at full-time first-degree studies – preliminary reports

INTRODUCTION

A search of the literature reveals that social skills, broadly defined by Blumberg et al. [1] as “skills and behaviours necessary to get along with others and be liked”, have a significant impact on academic achievements, such as grades in academic subjects, and on social achievements, such as the quality of relationships with peers [2]. In recent years, universities have observed a continued and dramatic increase in the number of students accessing mental health services, particularly for depression and anxiety [3, 4], and the COVID-19 pandemic is further exacerbating this problem. Research suggests that teenagers entering adulthood are particularly susceptible to experiences of loneliness [5]. Coping with new academic and social contexts requires the efficient use of social skills that vary among students.
With the increasing mental health burden among students, it is crucial to find ways to reduce it, especially in the case of depression and anxiety [3, 6]. Students experience many significant developmental moments during their academic experience, and their ability to cope with new academic and social challenges is crucial [7]. Although much attention is paid to the first year of studies, these challenges are also present in the subsequent years of study [8, 9]. Research indicates that social skills have a significant impact on mental health, and people with lower social skills may be more susceptible to experiencing depression and loneliness [10-12]. In the context of education and the professional environment, the development of soft skills is increasingly important for the effective functioning of an individual [13, 14].
In connection with teaching, it is important to understand how health care students go about developing these skills, primarily in interactions with patients who may be in a practical setting. The analysis of the impact of teaching on social development and relationship management in the context of applying practices that may be valuable for the nurse education process.
The aim of the project was to find out the level of soft skills among students of nursing and midwifery, full-time first-cycle studies, through their own analysis of the level of skill in initiating relationships with a known and unknown person, assessment of the level of assertiveness, ability to share personal information, readiness to provide emotional support to others, and interpersonal conflict resolution skills. To what extent does distance learning affect the level of interpersonal competences of first-cycle nursing and midwifery students.

MATERIAL AND METHODS

The pilot study was conducted in January in the 2022/2023 academic year. The study included a group of 62 second-year, first-degree nursing students of Collegium Medicum of the Jagiellonian University. The survey was voluntary and anonymous. The surveyed students had completed a series of classes on the optional subject Cooperation in the Health Care Team, which included 10 hours of lectures, 4 hours of theoretical exercises, and 6 hours of exercises in simulation conditions. The study group was planned to include students who studied remotely in high school during the last 2 years of the pandemic and had studied for at least one year. The inclusion criterion was the student’s informed consent to participate in the study by completing the survey.
The study aimed to determine the level of interpersonal competences in students’ self-assessment by assessing the initiation of relationships with a known and unknown person, to what extent the respondent assesses their assertiveness, to what extent they share personal information about themself and whether they are ready to provide emotional support to others. In addition, the ability to resolve interpersonal conflicts was also analysed.
The study was conducted using the Interpersonal Competences Questionnaire ICQ-R by Buhrmester, Wittenberg, Reis, and Furman (1988) in the United States of America. Dawidowicz, Klinktosz, and Śliwak from the Department of Social Psychology and Psychology of Religion at the Catholic University of Lublin adapted the questionnaire into Polish in 2015. The ICQ-R version A self-assessment questionnaire is used to predict the teamwork skills of a given person (employee, student). In total, 398 students were tested. The questionnaire contains 40 items and covers 5 dimensions of interpersonal competences: initiating relationships (IR), asserting influence (AI), self-disclosure (US), providing emotional support (EW), and conflict resolution (RK). Initiating relationships refers to initiating interactions and initiating interpersonal relationships with a known or unknown person. Asserting influence means declaring personal rights, dissatisfaction, and expressing criticism of other people’s actions. Self-disclosure involved sharing personal information about yourself. Providing emotional support is giving emotional support to others. Conflict resolution is the constructive resolution of interpersonal conflicts without quarrels and criticism of the opposing party. The developed questionnaire contains 3 versions: A – self-assessment, B – assessment of a friend of the same gender, and C – partner’s assessment. The study used version A. The respondent marks the result on a five-point scale, where 1 means poor and 5 means excellent. In each dimension, we obtain a raw score by summing the points and then comparing it to a group of norms developed separately for women and men aged 15-67 years. We obtain 10 results, where results of 40-60 T are considered average [according to the methodology of the Interpersonal Competences Questionnaire ICQ-R].
The consent from the Bioethics Committee of the Jagiellonian University no. 1072.6120.8.2023 of 15 March 2023 was obtained to perform the study.

STATISTICAL ANALYSIS

The results of individual domains of the Interpersonal Competence Questionnaire (ICQ) were expressed on a standard 10-point scale (T) and then divided into 3 groups: below the norm (< 40 T), within the norm (40-60 T), and above the norm (> 60 T). The analysis was performed both for continuous variables (on a standard 10-point scale), which were characterised by means with standard deviations (SD), and for categorised domains expressed by relative and absolute frequency. The statistical significance of differences in scores on a standard 10-point scale between gender and age groups (under 21 and at least 21 years old) was tested using Student’s t test with correction for unequal variances, after verifying the assumptions of compliance with normal distribution using the Shapiro-Wilk test and visualisation using histograms. Differences in frequencies for categorical variables were compared using Fisher’s exact test. The graphical presentation of the distributions is presented in the form of box and bar charts. All analyses were performed in the R program (Development Core Team, Vienna, Austria, version 4.0.4). Two-sided tests were used, with a set significance level of p < 0.05.

RESULTS

All ICQ-R domains had a normal distribution (Fig. 1).
The averages of the standardised scores on the standard ten scale, arranged in ascending order, were as follows: 49.9 for the assertive interaction (AO) domain, 50.0 for the emotional support (EW) domain, 50.5 for the conflict resolution (RK) domain, 50.7 for the initiating relationships (IR) domain, and 52.7 for the self-disclosure (US) domain. Values of results according to the ten scale that were within the norm were obtained by approximately three-quarters of students in the areas of initiating relationships and conflict resolution, then 67.7% in the domain of assertive impact, 64.5% in the domain of emotional support, and 61.3% in the domain of self-disclosure. The highest percentage of the sample exceeds the upper limit of the norm in the area of self-disclosure (25.8%), and the lowest in the areas of initiating relationships and conflict resolution (in both cases 14.5%). Ultimately, scores below 40 points on the standardised ten scale (lower limit of the norm) were obtained by 8.1% of students in the initiating relationships domain and 17.7% in the self-disclosure domain. Details are presented in Table 1.
Regardless of whether the main variables were analysed continuously (scores on the standard normalised ten scale) or categorically, no significant differences were observed in any of the domains or between genders (Tables 2 and 3, Figs. 2 and 3) nor between age groups (Tables 4 and 5) of people.

DISCUSSION

Interpersonal competences are valuable resources that allow people to enter into positive social interactions. Shaping and improving social skills, both verbal and non-verbal, helps maintain and strengthen social relationships and is particularly important in health care professions due to the specific nature of contact with patients. The analysis of the available literature in this field shows that they are not undertaken very often and are presented from different perspectives [13, 15-17].
Our own conducted research was of a pilot nature, and it indicates the further direction and need for continuation of research, as well as very preliminary trends in the examined issues. The assessment of interpersonal competences using the ICQ-R showed that in all the components tested, the participants mostly achieved the norm range, ranging from 77.4% in the area of initiating relationships, 74.2% in the conflict resolution component, 67.7% in assertive influence skills, 64.5% in the field of emotional support, and 61.3% in self-disclosure. It is worth noting that in the group below the norm, the highest percentage concerned the area of emotional support (17.7%) and assertiveness (16.1%), but it was above the norm in the components of self-disclosure (25.8%) and emotional support (17.7%). The conducted research also noted that women in all tested components achieved a higher percentage of the norm than the tested men. The trend was also evident in the analysis of data concerning the results below the norm. The analysis of data obtained from the questionnaire in relation to 2 age groups of respondents showed that in the older age group (22-30 years old), the study participants achieved a higher percentage of the norm than in the younger age group (19-21) in the components of initiating relationships and assertiveness. The older age group obtained values above the norm in the competence of self-disclosure, and the younger one in the competence of emotional support.
The study of social competences has taken on new meaning and value due to the experience of the pandemic and remote learning. With reference to the research of other researchers, it is worth mentioning the conclusions presented by Kotlinowska M., indicating the need to introduce various forms of development support and assistance in the form of mentoring, consulting, tutoring, or coaching to strengthen the sense of coherence and self-knowledge [16].
In turn, research conducted in a group of students by Wawrzyniec Romaniuk and Łukasiewicz-Wieleba indicates the value of direct contact in relationships with both lecturers and students and the need for non-verbal communication [18, 19].
In other studies, in the field of social competences among students of pedagogy, a demand was made to conduct classes conducive to the development of social competences and the need to measure them. Researchers point out the need to take into account both specific social competences, i.e. resulting from the professional profile, and non-specific competences, corresponding to the generally understood life activity of a graduate entering adulthood. These studies also pointed to students’ problems, which may manifest themselves in difficulties in establishing and maintaining direct relationships, self-presentation, negotiation, cooperation, and influencing others [15, 20].
The completed research is an attempt to draw attention to the need to conduct research in this area, both due to changes in social communication, the advantage of remote communication, and the experience of social isolation and lack of direct contact. The authors plan to continue research in this area in relation to the assessment of interpersonal competences assessed in students experiencing remote learning.
It is planned to increase the number of surveyed students and expand the study to include a group of students majoring in emergency medical services, which may provide a broader picture due to the larger number of male students compared to nursing and midwifery majors.

CONCLUSIONS

The level of interpersonal competences among the first-degree nursing and midwifery students is not high; however, the small number of students surveyed encourages continuation of research in this field. The results are similar when it comes to the level of the examined competences of the surveyed students. It is hard to determine the extent to which remote learning influenced the level of interpersonal competences of nursing and midwifery students, and no significant differences were observed depending on the gender or age of the surveyed students. The examined areas, i.e. the ability to initiate relationships with a known and unknown person, assertiveness, the ability to share personal information, the readiness to provide emotional support to others, and the ability to resolve interpersonal conflicts, show an average and low level in the majority of the surveyed students, which may suggest the impact of distance learning, but it is necessary is to conduct further research on an expanded group of students. It is planned to expand the group to include students of emergency medical services, which will introduce more variables such as gender and age and significantly expand the study group. The analysis carried out may also be an inspiration for academic teachers to modify the methods and tools used in the teaching process.

Disclosures

This research received no external funding.
The study was approved by the Bioethics Committee of the Jagiellonian University (Approval No. 1072.6120.8.2023).
The authors declare no conflict of interest.

References