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View of Effects of Group Art Program on the Self-leadership and Career Decision Self Efficacy of Nursing Students


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Effects of Group Art Program on the Self-leadership and Career Decision Self Efficacy of Nursing Students

Hyun-Jung Lee


, Ju-hee Hwang


1Professor, Department of Nursing, Kyungdong University, Medical Campus (WonjuMunmak), South Korea

*2 Professor, Department of Nursing, Kyungdong University, Medical Campus (WonjuMunmak, South Korea [email protected]1, [email protected]2*

Corresponding author*: mobile phone: +82-010-9139-1880


Objectives: This study aimed to assured the effects of group art program about the enhancement of self-leadership

and career decision self-efficacy of nursing students.

Methods/Statistical analysis: As an one group pre-post test research, total 340 students(first year) of nursing

department were selected as research subjects. The final research subjects were total 323 students excluding 17 students with insufficient responses. Total six sessions(100 minutes per session) of group art program were performed once a week from May to June 2019. As the effects of the program, the self-leadership and career decision self- efficacy were measured. Using the SPSS Window Version 25.0, the self-leadership and career decision self-efficacy were evaluated through mean, standard deviation, and paired T-test.

Findings: The consequence of this study, the career decision self-efficacy(t=-3.329, p=.001) was statistically

significant while the self-leadership(t=-1.388, p=.166) did not show statistically significant differences. Even though the self-leadership did not show significant differences, the goal setting(t=-2.530, p=.012) and constructive thought(t=-3.464, p=.001) of detailed items were statistically significant.

Improvements/Applications: The results of this research are highly meaningful in the point of verifying the effects of

group art program about the promition of self-leadership and career decision self-efficacy of nursing students who do not have clear goals of career.

Keywords: Group art program, Career decision , self efficacy, Self-leadership, Nursing student

1. Introduction

Nursing students who enter department of nursing have a strong belief in the profession of being a nurse compared to other majors and participate in college life with a prior choice of career, but there is a tendency that deep consideration of career path is lacking due to department adaptation and busy curriculum [1]. As belief in one's own abilities related to career, there is career decision self-efficacy, and it means confidence in self-action such as goal setting, plan establishment, problem solving, and evaluation [2]. Whereas, self-leadership, a notion that realizes the process of determining the right career path and achieving goals, is an internal motivation to set goals for oneself, self-control with autonomy, and is thought to have a affirmative effect on career decision self-efficacy [2].

Art programs lead the way to experience failures, corrections, and successes that one chooses and creates, and can create a clear visual goal as a work of art. In addition, it has the advantage of being able to acquire naturally clear results while actively and proactively exploring and attempting through art media and creative processes, which are difficult to express in language [3].

Group art programs motivate members with the same problems in the group to accept psychological problems and have a positive and active attitude through empathy and support [4].

While there are studies on effects of group art programs on career decision self-efficacy [4-6], problem solving capacity [4], subjective well-being [7], career identity and career decision level [3, 8], and career and employment stress[8, 9] in college students, as well as a study of meta-analysis of career-related art therapy effects [10], there are lack of studies that analyzed the effects of applying group art programs to nursing students.

Therefore, this study aims to testify the effectiveness of group art programs by comparing before and after whether group art programs promote self-leadership and career decision self-efficacy of nursing students.

2. Method

2.1. Design and Subjects

This reserch is an experimental study of before and after comparison of a single group to evaluate the effects of group art p rograms on self-leadership and career decision self-efficacyof students. The subjects in this study were 1st year nursing students located in W city in Korea, and among the students who participated in group art programs, those who understood the goal of this reserch and co nsent to take part in [Table 1].


The number of participants was measured using G* Power Program, and a total of 340 people were selected in consideration of the dropout rate. The final study subjects were 323 subjects excluding 17 insufficient responses.

Table 1: Research design

Group Pre-test Intervention Posttest

Experimental group Ye1* X** Ye2***

*Ye1: General characteristics, Career decision self-efficacy, Self-leadership

**X: Group art programs

***Ye2: Career decision self-efficacy, Self-leadership

2.2. Tools

The questionnaire consisted of 6 general characteristics, 25 career decision self-efficacy and 18 self-leadership questions.

To measure career decision self-efficacy, the CDMSES-SF (Career Decision Self-Efficacy Scale-Short Form) developed[11]

and adapted [12] was used, and it consisted of 5 sub-factors, a total of 25 questions, in a Likert 5-point scale. The Cronbach's α in study was .91.

For the self-leadership scale, it was measured with a tool developed in 1992 [13] and modified and supplemented [14]. This tool consists of a total of 18 questions, 3 questions each for 6 sub-factors. Each question is on a 5-point scale, and the higher the score, the higher the self-leadership. In Precedent study[14], Cronbach's α was .87, and Cronbach's α in study was .85.

2.3. Procedure

In this study, a masterpiece drawing art therapy program was developed for freshmen who entered nursing college. This program was conducted with the aim of creating rapport among group members of 4 per group and inducing interest in art therap y.

Looking at the format of the program, it can be divided into introduction, main activity, and closing. First, participation in this activity is induced through introduction activities before the start of the program, and the activities that will be performed at that time is introduced at the beginning of the program. Then, the main activity was followed, after which is time to share the feelings of the group members about the activity and exchange feedback, so that the activities of the day could be organized. In this program, individual and group work was conducted according to the topic of each session. This program was held every Wednesday from May to June 2018, for a total of 6 sessions of 100 minutes, once a week, and on July 1st, an exhibition and evaluations were conducted. The venue was located in a lecture hall at K University. Prior to the program, students were asked to agree to participate in the program, and preliminary tests (general characteristics, career decision self-efficacy, self-leadership) were conducted, After program was terminated, self-leadership and career decision self-efficacy tests were again conducted to find out the effectiveness of the program.

2.4. Data Collection Method

In this study, the group art program was conducted once a week from May to June 2018, 100 minutes per session, for a total of 6 sessions, and pre- and post-tests were conducted one week before the beginning of the program and one week after the end of the program.

Prior to participation in the practice, the goal and method of the study were given an explanation and consent was obtained in writing from the subjects who give assented to take part in the study. It was fully explained that since the survey is conducted before and after the participation in the training, the intention to participate can be changed at any time, and that there is no disadvantage.

2.5. Data Analysis Method

The gathering data were processed with SPSS version 25.0, and analysis methods were descriptive statistics, independent t-test, Cronbach's α, Pearson's correlation coefficients.

3. Results

3.1. General Characteristics of Study Subjects

As a result analyzing the general characteristics of subjects, average age was 18.7 years old, female students 81.4% (263 people) and male students 18.6% (60 people). The most common motive for choosing the department of nursing was “Considered employment” with 48 .3% (156 people), “Encouragement by parents” with 12.4% (40 people), and “Community service” with 11.5% (37 people). As for relationships, 57.3%

(185 people) answered “Good”, and 39.0% (126 people) answered “Average”. As for self-expression, “Good” was the most common with 43.7% (141 people), and 40.2% (130 people) answered Average. Satisfaction with the major was 6.04 points, which was above average [Table 2].


Table 2: General characteristics of the subjects (N=323)



Leadership and Career Decision Self-Efficacy Before and After Group Art Program

In career decision self-efficacy before and after group art program, it increased from 3.84 (±.48) points to 3.97 (±.56) points from before group art programs, and was statistically important (t=-3.32, p=. 001). Among the career decision self-efficacy areas before group art programs, the lowest was <plan establishment> with an average score of 3.71 (±.57), and afterwards it was also <plan establishment>, where the average score was 3.93 (±.59). Among the career decision self-efficacy areas before group art programs, the highest area was <goal setting>, with an average score of 3.92 (±.59), and afterwards it was also <goal setting>, where the average score was 4.01 (±.59). Self-leadership before and after the group art program increased from 3.83 (±.50) before group art program to 3.88 (±.52) after program, but it has no statistical importance (t=-1.38, p=.166). Looking at the sub-area of self-leadership, it was statistically significant in <goal setting> (t=-2.53, p=.012) and <constructive thinking>

(t=-3.46, p=.001) [Table 3].

Table 3: Self-leadership and Career decision self-efficacy before and after group art program (N=323)


Pre-test Post-test

t p

Mean (SD) Mean (SD)

Career decision self-efficacy

Total 3.84(0.48) 3.97(0.56) -3.32 .001

Job information collection

3.85(0.56) 3.94(0.60) -2.10 .036

Goal setting 3.92(0.59) 4.01(0.59) -2.01 .044

Plan establishment 3.71(0.57) 3.93(0.59) -4.92 <.001

Variable Characteristics n (%) or M±SD n(%)

Age 18.7±1.09


Male 60 18.6

Female 263 81.4

Admission motivation

Encouragement by parents 40 12.4

Encouragement by teachers 5 1.5

Considered employment 156 48.3

Community service 37 11.5

GPA 14 4.3

Others 71 22.0


Good 185 57.3

Average 126 39.0

Difficult 12 3.7


Good 141 43.7

Average 130 40.2

Difficult 52 16.1

Satisfaction with major 6.04±1.75


Problem solving 3.80(0.62) 3.96(0.65) -3.31 .001

Self-evaluation 3.91(0.53) 4.00(0.59) -2.19 .029


Total 3.83(0.50) 3.88(0.52) -1.38 .166

Self-expectation 3.95(0.62) 4.00(0.64) -1.13 .259

Rehearsal 3.94(0.72) 3.95(0.71) -.072 .943

Goal setting 3.83(0.66) 3.96(0.66) -2.53 .012

Self-compensation 4.13(0.64) 4.09(0.64) .758 .449

Self-criticism 3.53(0.83) 3.53(0.91) .059 .953

Constructive thinking 3.57(0.75) 3.76(0.72) -3.46 .001

3.3. Correlations for Self-Leadership and Career Decision Self-Efficacy

As a result of analyzing the correlation between self-leadership and career decision self-efficacy of nursing students who experienced the group art program in this study, there was a positive correlation that has statistically signification [Table 4].

Table 4: Correlations for Self-leadership and Career decision self-efficacy (N=323)


4. Discussion

This study had the goal to examine the effect of the group art therapy program for freshmen who are currently enrolling in university on their self-leadership and career decision self-efficacy. Through group art therapy, students voluntarily participated in art activities to explore themselves freely and express their feelings, inducing them to have various positive experiences. In the early stage of group art therapy, the students had an awkward atmosphere among members, and their belief in the effect of art therapy was not firm, but gradually began to actively participate in art therapy as the program progressed. The researcher attempted to create a group atmosphere so that students could have a positive influence on each other by creating an atmosphere in which students can share various experiences on the subject of art works and share information. In addition, it helped to restore confidence by supporting stories of individuals and to gain a positive perception that they can do it with confidence in their future career. Discussion based on the conclusion of this study and previous studies is as follows.

First, the career decision self-efficacy of college students who experienced group art therapy improved compared to before group art therapy. This is the result that group art therapy's effect was positive in career decision self-efficacy of college students.

In addition, it is partially consistent with the results of previous studies that reported that group art therapy held the affirmative function on career decision self-efficacy of college students [15], and it is consistent with the view that art therapy helps to experience emotional change and psychological tension relief in the process of safely expressing and dealing with individual psychological difficulties [16]. A preceding researcher, who provided art therapy by applying collage technique to college students, saw that art therapy had a positive effect on their career identity and career decision level[3], and this result is in the same context as this study. In addition, it positively influenced career decision self-efficacy through verbal persuasion such as praise and encouragement among members. Particularly in the 6th session, students took time to discover their strengths and connect them with their chosen profession. They can be seen as having a affirmative influence on career decision self-efficacy by enhancing self-efficacy by explaining and presenting their strengths with confidence, and by linking this to their career factors.

Second, as a result of investgating the effect of group art therapy program on self-leadership of university students, the results of comparing before and after receiving art therapy were not significant, but there were statistically significant differences in goal setting and constructive thinking strategy scores, which are sub-variables of self-leadership. These outcomes were partially coincided in preceding studies such as group art therapy for self-leadership improvement [17], and group art therapy-based self-


Career decision self-efficacy

Self-leadership r(p)

Career decision self-efficacy 1

Self-leadership .747** 1


leadership program [18]. This shows that college students in department of nursing understand themselves by participating in group art programs, and through the process of finding each individual's potential, it means that self-esteem has increased by experiencing various senses of accomplishment, and sociality leading to positive relationships through interaction with group members has improved. From these results, the group art therapy program was effective in providing a positive self-understanding process to college students, who are in the middle of finding and establishing self-identity. As described above, group art therapy was found to be effective for college students who did not have a clear goal for their career path, in that it helped to examine one's interests, aptitudes, and values about his or her job, set goals for oneself, plan to move toward it, and set one's own career path.

5. Conclusion

This study attempted to verify the effectiveness of group art programs to enhance self-leadership and career decision self-efficacy of nursing students. As a result, group art programs showed high effectiveness in career decision self-efficacy, and although partial in self-leadership, it was effective in goal setting and constructive thinking. Accordingly, it was confirmed that group art programs can improve the career decision self-efficacy of nursing students, and that there is a correlation between career decision self-efficacy , self-leadership.

6. Acknowledgment

This study was supported by the Program funded by Kyungdong University.

7. References (APA)

1. Moon. J. Y. (2019). Mediating effect of self-leadership and career decision self-efficacy on the relation between crit ical thinking disposition and career preparation behavior in nursing students. Jour. of KoCon. a, 19(11), 462-73. D OI:10.5392/JKCA.2019.19.11.462

2. Kim N. S. & Ko Y. J. (2020). Relationship between self-leadership, career decision self-efficacy and career identity of nursing students. Journal of Digital Convergence, 18(1), 211-218. DOI : 10.14400/JDC.2020.18.1.211

3. Son E. J. & Shin. J. H.(2018). Effect of collage-applied group art therapy on the career identity and career decision level for university students. Korean Journal of Educational Therapist, 10(3),429-45.

4. Oh. H. S. (2019). The Effects of resolution oriented art therapy on crucial career decision self-efficacy and problem- solution ability of university students. Korea Journal of Art Therapy, 26(3), 487-507.

5. Lee. Y. R. (2017) The effect of art therapy on college students' self-resilience, career decision- self-efficacy and car eer maturity. Master's thesis. Cha University, Seongnam, Korea.

6. Hwang. S. Z. (2019). A Study on the effects of the solution-focused group art therapy program to enhance career de cision self-efficacy; focused on the career preparation behavior of college students. Unpublished Doctor’s thesis, Daegu University. Daegu. Korea.

7. Lee H. J. & Kim J. E. (2020). The effects of positive psychology-based group art therapy on the self efficacy and su bjective happiness of art therapy major students. Korean Journal of Art Therapy, 27(3), 493-512. DOI :10.35594/k ata.2020.27.3.005

8. Park H. W.(2019). The effects of group art therapy on the career stress and career decision level of university Stude nts. Unpublished Master’s thesis, Konkuk University, Seoul, Korea.

9. Roh I. S. & Chun S. Y. (2019). The effects of group art therapy using color psychology on the employment stress a nd emotional stability of university students. Journal of Arts Psychotherapy 15(1), 259-84. DOI: 10.32451/KJOAP S.2019.15.1.259

10. Kim E. C. & Lee K. M. (2020). A meta-analysis of the effect of career-related art therapy.

Journal of Arts Psychotherapy, 16(2), 137-63. DOI: 10.32451/KJOAPS.2020.16.2.137 11.Taylor, K. M. & Betz, N.(1983). Application of self-efficacy theory to the understanding and treatment of career in decision. Journalof Vocational Behavior, 22, 63-81.

12. E. K. Lee.(2001). A study on the effect of self-efficacy upon the career development, Ewha Woman’s University, Doctoral dissertation.

13.Manz C. C. (1992). Mastering self-leadership: Empowering yourself for personal excellence. Englewood Cliffs, New Jersey: Prentice-Hall.

14. Kim H.S. (2003). The relationship between teacher’s self-leadership and the job satisfaction at secondary schools master’s thesis. Seoul: Soongsil University.

15. Shin Z. Y.(2014). The effects of group art therapy on reducing life stress of University students with self

oriented perfectionism. Hanyang University, Master's thesis.


16. Kramer E. (2007). Art as a Treatment: Cramer's Art Treatment. Seoul:Sigmapress.

17. Choi E. H. (2011). Efficiency study of combined group art therapy to improve self leadership for high school students in professional school : focusing on self leadership, sociality and self-worth. Hanyang University, Master's thesis.

18. Wee K., Kim B. J. & Kim J. H.(2012). The Effect of the self-leadership program based on group art therapy on

learning motivation and problem behavior in children from low-income families. Korean journal of youth

studies,19(7), 137-164.



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