In the present study, no significant difference regarding the scores of professional values between the two groups of students was identified. Findings of the present study suggest that all of the Iranian nursing students, whether graduating from type I or III universities contemplate professional values as important issues in nursing. According to the five-point Likert scale, total mean scores of students in type I and III universities corresponds to the statements of important to very important, respectively. In general, our results are similar to the findings reported by previous studies (
16, 17); however, nursing students in this study had lower NPVS-R mean scores compared to the students of other studies ( 2, 18). Despite the ranking of medical sciences universities in Iran into three types, these universities have probably educated their students in a somewhat similar manner about professional values. Similar to the current study, the statements “maintain confidentiality of patient”, “maintain competency in area of practice”, “seek additional education to update knowledge and skills", and "protect moral and legal rights of patients” were highly rated among subjects in previous studies; meanwhile the “participate in peer review", "participate in public policy decisions affecting distribution of resources" and " participate in nursing research and/or implement research findings appropriate to practice" statements obtained the lowest level of importance ( 2, 16, 18, 19).
In the study of nursing students' ideals in England, Maben et al (2007) reported that values among graduating nursing students are closely related to the patient care (
20). Moreover, other studies have indicated that students would best perceive and integrate the values that are related to the patient care ( 2, 19, 21). Providing care for patients is the cornerstone of codes of ethics in nursing ( 22). The nurses are expected to provide care with a respectful competent behavior and without prejudice toward patients ( 23). Since patient care is a prominent part of nursing education, one would expect the values related to care to be rated as the most important professional values by students ( 2). As a matter of fact, it is well identified that nurses would highly count the values directly associated with clinical work and patient care as important ( 2); however, values not directly related to patient care such as participating in nursing associations and research activities did not possess such high level of importance. Reports have shown that appropriate educational curricula can improve students' views towards this group of values as well ( 16). In addition, each value possesses an emotional dimension ( 24). In this regard, if a value develops during the first or two stages of emotional learning, while it is not literally encouraged or practically approached during formal education, the importance of that value might be deserted by students ( 25). Furthermore, examination of the two groups of participants in terms of families' economic situation revealed significant differences in all of the NPVS-R statements. As previously described in literature, it is possible that good to moderate economic situation can lead to a more effective performance without any concerns towards the professional practice ( 26).
Several limitations in this study should be noted. Firstly, this study was conducted in a cross-sectional design, while the longitudinal follow-up of students would most likely provide a more correct picture of the educational development. A replication of this study could be useful with the same students in years after graduation to identify whether their professional values have changed or remained the same. Future studies should comprise nursing educators' competency and educational techniques in the area of professional values. Future studies are also required to identify how faculty role models, clinical staff and educational experiences may facilitate the development of professional values.
In conclusion, we showed that the educational ranking of medical science universities in Iran is not correlated with their students' perspective about professional values. Moreover, we showed that students who were on the verge of graduating and entering to independent field of nursing practice, obtained mean scores in the range of important to very important; however, such highly rated items were directly associated with nursing clinical work. Thereby, there is a pressing need toward disclosing the importance of non-clinical professional values such as evaluating and monitoring colleagues, participating in professional associations and research activities among nursing students. The main factors contributing to the development and learning of professional values are educators, students, faculty, clinical experience, presentations, patient care and personal values (
23). Therefore, enhancing professional values in nursing students and transforming current students into future's empowered nurses who are able to undertake a wide range of activities, necessitates comprehensive development of educational schedules appropriate for the present conditions.