Evaluating the service quality of undergraduate nursing education in Taiwan – using quality function deployment
Introduction
In recent years, higher education in Taiwan has expanded at an extremely rapid pace. In the past decade alone, the number of colleges and universities in Taiwan has tripled to 160 (China News, 2003). This rapid expansion has placed the dream of obtaining a university education – a dream formerly achieved by only a select minority of students – within the reach of most high school graduates. At the same time, however, expansion has increased concern about maintaining the quality of higher education in Taiwan. The government has recognized the vital link between the quality of undergraduate education and competitiveness in the global economy. In addition, educational institutions are now facing increased pressure to recruit students and must strive to make their programs more attractive. These factors have heightened interest in developing effective means of quality management for educational programs; as a result, educators in Taiwan are turning their attention to models of quality management developed in the business world (Kao, 1998). The best known of these models, total quality management (TQM), is already being implemented in approximately 75% of institutes of higher education in the US (Horine and Hailey, 1995). Because activities being carried out within academic environments do not differ greatly in their quality characteristics from the activities being carried out by manufacturing and service industries (Owlia and Aspinwall, 1998), it is not surprising that academic enterprises are benefiting from applications of TQM. Positive results include increased customer satisfaction, higher productivity, and improved student/staff morale.
In the field of nursing education as well, quality management using TQM principles is attracting growing research interest (Grant et al., 2002). Nurse educators have recognized the need to refine the research tools being used to study the quality of nursing education and to focus them on the evaluation of program outcomes (Cook, 1997; Tanner, 2001). One powerful TQM tool, quality function deployment (QFD), is now being used in educational settings (Bier and Cornesky, 2001; Chang and Chou, 2001; Lian, 2001) and has been successfully applied to the field of nursing education (Shaffer and Pfeiffer, 1995), although research is still in a pioneering stage. The current study applies QFD to evaluate the quality of service of undergraduate nursing education in Taiwan. The study was undertaken with three basic goals: (1) to explore discrepancies between quality characteristics desired by students and the service elements provided by academic institutions, (2) to understand the most important and the least important service elements in undergraduate nursing education from the perspective of the students, and (3) to describe the quality requirements of undergraduate nursing education in relation to the important service elements.
Section snippets
Literature
The ultimate goal of QFD is to translate customer requirements – the so-called “voice of the customer” (VOC) – into quality characteristics of the final product or service. QFD provides a systematic method of determining customer needs, prioritizing them, and translating them into product design parameters. In business settings, such design parameters are frequently checked against customer needs throughout the product development cycle to ensure customer satisfaction with the end product (
Sample group
The study group consisted of undergraduate nursing students from two national universities and two private universities in Taiwan. Of 630 students selected to participate in a questionnaire survey, 560 responded (response rate of 89%). Demographic data for the subjects are shown in Table 1. The study group consisted of 460 (82%) female students and 99 (18%) male students. Among the respondents were 224 (40%) sophomores, 169 (30%) juniors, and 163 (29%) seniors. The majority of students had
General results
Of the 560 students who responded to the survey, 267 (48%) students described themselves as either interested or very interested in studying nursing. In addition, student responses indicated only moderate levels of satisfaction with the education they were receiving. About 224 (40%) students indicated they were satisfied or very satisfied with their undergraduate nursing education versus 243 (44%) who described their satisfaction level as fair. When asked if they would encourage others to study
Discussion
The results of this QFD study highlight the importance of faculty characteristics in the quality of undergraduate nursing education in Taiwan. It is noteworthy that seven of the top ten quality requests are characteristics of instructors: knowledge of the field, abundant clinical experience, commitment to teaching, ability to demonstrate nursing skills, clarity of teaching, fair and objective evaluation of students, and the ability to bridge theoretical and clinical aspects of nursing. If the
Conclusions
This study suggests that the key to satisfying the customer requirements of nursing school students in Taiwan lies in redoubling efforts to strengthen the traditional staples of undergraduate nursing programs – clinical practice and lectures. From the perspective of students, the key to quality in both areas lies in faculty characteristics. The implication is that, although institutions are facing intense pressure to compete in offering students the most up-to-date physical facilities and
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