Communication is an inevitable part of our human existence, yet in the nursing profession, communication barriers are commonplace. Even when the professional nurse speaks effectively, precisely, and deliberately, common interferences such as age, time deficits, culture, and technology can affect patient care in a negative manner. Ineffective communication interferes with collaboration among caregivers and can result in errors including wrong-site surgeries, medication errors, and mistaken patient identities (Emanuel, 2013).
Nursing students are taught theoretical knowledge about communication, but they are not always taught how communication preferences affect their patients and fellow team members (Yuh-Shiew et al., 2014). The problem identified in this pilot study is the lack of education on recognizing individual communication styles. The first step in solving this problem is to help students identify their own personality preferences and communication styles. The Myers-Briggs Type Indicator (MBTI) provides guidelines on how individuals process information, make decisions, and communicate within their personality preference style, specifically introversion and extroversion.
BACKGROUND
The MBTI is used to describe how individuals interact with their environment through the identification of four preference pairs that are combined into 16 psychological types (Myers, McCaulley, Quenk, & Hammer, 1998). It uses Jung's psychological principles of how individuals perceive information, both consciously and unconsciously.
Introvert and extrovert (EI) types are the first preference pair. Introverted types focus their thoughts around their inner world experiences and carefully process and reflect on the data they collect. Extroverted types are able to quickly express and outwardly describe the "big picture." They enjoy interacting and are energized by other people. Introverted types develop concepts and ideas before speaking, whereas extroverted types are focused on speaking out, using action terms (Myers et al., 1998).
Sensors and iNtuitives (IN) are the next preference type. Sensors prefer to process information by piecing together facts. Their questions revolve around choosing the precise answer, whereas intuitives are more abstract, often describing their findings in vague, general terms. Thinkers and Feelers (TF) are the preference pair associated with how individuals make decisions or judgments. Although thinker types prefer to weigh the evidence in an objective fashion, feeler types value the opinions of others and may lean on others to resolve complicated situations (Plonien, 2015). Judging and Perceiving (JP) is the preference pair that addresses the way individuals structure their lives. Judging types want to organize their lives and get tasks done by organizing detailed procedures. Perceiver types are described as being more curious and prefer to delay decision-making until they have all the information.
LITERATURE REVIEW
Strategies for improving communication techniques in nursing school curricula have been thoroughly outlined in the literature, with less attention given to communication preferences and how they relate to safety in the workplace (Emanuel, 2013; Yue-Shiow et al., 2014). Introducing communication preferences into the nursing curriculum with simulation labs helps rectify this problem, actively transferring interpersonal communication techniques from the classroom into simulation labs (Yue-Shiow et al., 2014).
The MBTI framework offers insight into communication patterns through exploration of type preferences and variables such as writing, communicating, and working within a group (Yue-Shiow, et al., 2014). Self-awareness of preference toward introversion or extroversion communication styles helps the student be more accommodating to the patient and other health care workers (Emanuel, 2013; Myers et al., 1998).
MBTI research demonstrates that 58 percent of nursing students in the United States have a tendency toward extroversion as a group norm (Yue-Shiow et al., 2014). The MBTI modal nursing student type is ESFJ. This type exhibits preference for collaboration and teamwork but is not associated with a specific gender (Myers et al., 1998). Educators should be cautioned about acknowledging only one type of personality preference since personalities can easily change due to specific situations or stressors.
The conceptual framework used for this pilot study was Bandura's (1977) social cognitive theory. This theory uses self-efficacy as scaffolding for learning individual communication behaviors. It provides insight into the individual's communication preference by having the educator illustrate preferences that a student may recognize and build upon. The theory provides structure on the persistence and effort of the individual during the act of communication. Educators can improve their students' communication techniques by assessing and correcting their beliefs about their own communication styles.
METHOD
The purpose of this quantitative correlational pilot study was to investigate if a relationship exists between male and female nursing students and communication characteristics of introversion and extroversion. The research question asked: Are proportions associated with preference for introverted or extroverted communication preferences the same for male and female nursing students?
The study employed a quantitative correlational design to describe and measure relationships between communication characteristics of introversion and extroversion and the gender of nursing students. The nominal data generated from the MBTI instrument were analyzed and confidentiality was maintained.
After gaining approval by the institutional review board, three sets of first-year nursing students enrolled in a two-year associate of science in nursing program were selected in a nonrandom purposeful manner and asked to complete the MBTI instrument form M. Forty-seven nursing students participated, 41 female and 6 male. Students were non-Hispanic whites and one African American student. Participant ages ranged from 19 to 45.
Instrument
The MBTI instrument scores predict four basic personality types arranged in 16 different patterns. The MBTI form M has been shown to rank individual participants with 58 percent to 78 percent accuracy to their type (Yuh-Shiow, Wen-Pin, Chin-Fang, Sue-Heui, & Bao-Haun, 2014). The MBTI Pearson r ranges from .69 to .83, noting consistency and reliability with alpha at .05 (Schaubhut, Herk, & Thompson, 2009). Retest results demonstrate preference types remain the same 75 percent to 90 percent of the time (Schaubhut et al., 2009).
Data Analysis
The MBTI questionnaire provided the data for this pilot study. A correlational analysis was performed incorporating the nonparametric Pearson's chi-square test for independence. An alpha level of .05 was assigned to the Pearson's chi. Test scores were given to each student along with an explanation of the results.
RESULTS
The calculated Pearson chi-square of .733 is greater than .05; therefore, the results are not considered significant. The standard critical value table has determined that, at a degree of freedom of 1 and a p value of .05, the critical value is 3.84. This value of .733 determines no relationship between gender and introversion and extroversion personality traits. There were more introverts than extroverts in this population, with female students in the majority. The chi-square statistic suggests that male students were more likely to be extroverted.
Several limitations to the study were identified: a small sample size, lack of diversity, and participants may have felt pressure to volunteer. In addition, the emphasis was only on extroversion and introversion.
DISCUSSION
The literature states that nursing students who preferred extroversion in their communication styles were female (Myers et al., 1998). This is in contrast to the findings of the study, where the proportion of male and female nursing students was nearly the same for introversion and extroversion. Because of the complexity of the health care setting, a priority in nursing education should be how to best teach introversion and extroversion communication preferences to students for the provision of safe patient care. This would include offering the MBTI early within the nursing program. More research on the MBTI modal type ESJF as representative of nursing students would be another area of exploration for nursing education.
CONCLUSION
Both introverted and extroverted types of personality preferences bring strengths and weaknesses to the health care setting. The majority of the participants in this study were introverted, in contrast to the modal nursing student personality type of ESFJ. Tolerance for each type of communication style should be valued.
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