A PROFILE OF THE REGISTERED NURSE TUTOR IN THE RSA H. I. L. Brink

Introduction with those of other tertiary educators in Abstract It is just over six and a half decades ago the country? are they engaging in tiiat the first quahfied sister tutor (now The purpose o f this study was to continuing education to upgrade their designated nurse tutor) was appointed in explore and describe selected demo- qualifications? are they in a position to this country. South Africa’s first sister graphical, biographical, educational enact the scholarly role expected of tertiary tutor, a single young female, was recruited and professional background educators? are they maintaining contact from England and held the distinction of characteristics o f the registered nurse with the practical realities of nursing being a gold medalist of the Nightingale tutors in the RSA and to construct a through involvement in the clinical field? profile o f the characteristics. Such a School of St. Thomas Hospital London were being asked. and a qualified sister tutor from King’s profile could provide a baseline for A need for a systematic investigation of future studies and evaluation College, University of London. (Searle. the nurse tutor in the RSA was therefore 1964). She was thus qualitatively well concerning registered nurse tutors. identified. Findings from such an prepared in both nursing and teaching. Data were collected from a random investigation would provide factual The standard of her tutor’s qualification proportional stratified sample of 233 information to verify or dismiss the registered nurse tutors from a total o f was on a par with that of other teacher’s concerns that were being expressed. 1312 registered tutors whose names lifications in the country at that time Furthermore such information might be ;l) and she was an experienced nurse. appeared on the SANC register. A valuable to nurse leaders to identify questionnaire developed by the « She was well suited to the responsibilities deficiencies and needs in respect of nursing allocated to her, namely to take charge of researcher and based on and adopted education to-day and could provide a the probationer nurses of the newly from a questionnaire from the Research baseline for future studies and evaluations established Preliminary Training School Triangle Institute USA on the concerning the registered nurse tutors. for nurses of the Johannesburg Hospital registered nurse in the USA, was used This report describes some of the and to give lectures and demonstrations on for data collection. The data were findings of part one of the investigation nursing matters. analysed and from the findings a profile carried out in 1983-84 on the registered Almost a quarter of a century later in o f the registered nurse tutor in the RSA nurse tutor in the RSA. 1945, when the first College of Nursing was constructed. The purpose of the study was established in this country and just Uittreksel before the South African Nursing Council The study referred to in this report was (SANC) resolved to institute an additional Die doel van hierdie studie was om undertaken to explore and describe register for sister tutors, the number of geselekteerde demografiese, biografiese, selected demographical, biographical, qualified practising sister tutors in the opvoedkundige en professionele educational and professional background country had risen to twenty-nine. (Searle agtergrond eienskappe van die characteristics of the registered nurse 1964a; 189). W ith such small numbers geregistreerde Verpleegdosent in die tutors in the RSA and to construct a common characteristics of tutors could still RSA te identifiseer en te beskryf en om profile of the characteristics. be identified and recorded, and ’n profiel van hierdie eienskappe op te information including the personal and stel. So 'n profiel sal as basis vir verdere Definition of terms educational background on many of these studies en evaluering met betrekking tot Profile as used in this report refers to an early pioneers can be found in the die geregistreerde verpleegdosent kan outline or schematic description of the J ^ a tu re (Harrison 1979; Searle 1964). dien. Data is ingesamel van ’n main features or characteristics of a set of ^ÍF ro m the literature the following profile ewekansige, proporsionele, gestra- individuals (a sample of registered tutors). emerges. These early pioneer tutors were tifiseerde steekproef van 233 all experienced nurses, who were highly geregistreerde verpleegdosente vanuit ’n Registered nurse tutor thought of in the profession. They were totaal van 1312 geregistreerde dosente Throughout this report the concept motivated teachers who had undergone wie se name op die SA VV registers “registered nurse tutor” is viewed in a their tutor training at considerable verskyn. ’n Vraelys gebaseer op die van broad sense and refers to all professional financial sacrifice. They were all females die Research Triangle Institute, VSA nurses who have had the additional mostly in their late twenties or early oor die geregistreerde verpleegkundige qualification of nurse tutor entered behind thirties and unmarried and the majority in die ySA is deur die navorser their name in the SANC register for tutors, used their teaching experience as a ontwikkel en gebruik om data te regardless of whether they are actually stepping stone to higher posts in nursing versamel. Die gegewens is geaniliseer en engaged as teachers or not. administration. Before they got there ’n profiel van die geregistreerde dosen! however, they had all rendered significant in die RSA is opgestel. Population and Sample services to nursing education. All persons whose names appeared on the In 1983, when preparations were well obtained from the SANC register, no SANC register for tutors on July 28, 1983 ahead for the transition of the nursing information on educational or professional and who were residing within the borders education system of this country into a background and experience was available of the RSA formed the population. From university-linked secondary education from the register or could be traced from the total population of 1 312 registered system, the number of qualified nurse any other published literature or record. nurse tutors residing within the borders of tutors whose names were entered into the At this point of time such information the RSA (another 190 from the total of SANC additional register for tutors, was would have been useful. Doubts and 1 502 names listed in the register resided 1502 (SANC 28.7.83). With such large concerns were being voiced in several outside the borders of the RSA) a numbers identification of common nursing circles as to whether the current proportional stratified sample of 451 based characteristics of tutors was of course no nurse tutors had sufficient background on population group and gender was longer possible. While information such as experience and advanced knowledge to randomly selected. This constituted a 39,39 names and addresses, gender and cope with the demands of the time and the percent sample fraction. Two-hundred and population or language group of all knowledge explosion. Questions such as, thirty-three registered tutors (17,5% of the persons registered as tutors could be are the nurse tutors qualifications on a par total population) eventually participated in

Vol. 11, No. 1 1 teachers of nursing, while 31 percent are TABLE 1: TOTAL POPULATION, SELECTED SAMPLE AND PARTICIPATING employed in a capacity other than SAMPLE USED FOR THE STUDY teaching. Total Population Selected Sample Participating Sample Age Female Male Female Male Female Male The age distribution of the registered nurse A siatic 22 3 9 6 tutor ranges from below 25 years to over Black 250 9 83 41 55 years, with only 1 respondent (0,4%) C o lo u red 102 2 34 13 below the age of 25 and 27 (11,6%) above W hite- the age of 55. On the whole, registered A frik aan s 547 23 182 96 nurse tutors are chronologically mature women, with those in other than teaching W hite- posts tending to be somewhat older than E nglish 351 3 117 3 64 2 their counterparts in teaching posts. T o tal (1 2 7 2 40) (425 26) (220 13) Almost one-half of the non-teaching group 1312 451 233 (46%) is above the age of 45, while 28 percent of the teaching group is found in this age group. Of the latter group more than a half (51%) fall in the 35-44 age the study. Table I provides more details of the registered nurse tutor of the 1980’s groups. The median age of the teaching the total population, selected sample and em erged. group is 40 years against that of 43,2 years participating sample. for the non-teaching group. Findings The Research Instrument Marital status and dependants DEMOGRAPHICAL AND Unlike the nurse tutors of the pre-world With respondents widely dispersed BIOGRAPHICAL DATA throughtout the RSA the self-administered war 2 era who were mostly single w om ej^^ These data include population group and mailed questionnaire was considered to be without dependants, only 31 percent of the the most suitable instrument to gather data gender, employment status, age and registered nurse tutors of the 1980’s have marital status and dependants. from the selected sample. The ques­ never been married and only 35 percent tionnaire was developed by the researcher. have no dependants. Part 1 of the questionnaire (the part Population groups and gender pertaining to this report) contained 74 As reflected in Table I, the total registered EDUCATIONAL BACKGROUND items requesting background information nurse tutor population of the 1980’s is still These data include background of such as age, sex, marital status, educa­ predominantly female. Only three percent mathematics and science, type of basic tional background, years of experience in is male. Roughly 2 percent belong to the nursing programme completed and type of nursing and nursing education and so on. Asiatic population group, 19,7 percent are programme completed to first register as The items were based on a National Black, 7,9 percent Coloured, 43,4 percent nurse tutor, participation in continuing Sample Survey of registered nurses in the White Afrikaans and 26,98 percent White formal education and additional post­ USA questionnaire developed by the E nglish. registration courses. Research Triangle Institute, but were adapted to the local situation. A number Employment status Background o f mathematics and science of items specific to the South African Of the 233 respondents 87 percent are in Only 39,9 percent of registered nurse tutors nursing situation were added. Most of the full-time employment, 4 percent in part- haVe a matriculation level background in items were of the forced-choice type and time employment and 9 percent are not mathematics, and only one-third of the required only check marks as responses. employed or were retired. Only 60 percent group has a matriculation background of Spaces were provided for any additional of the respondents are employed as physical science and chemistry. comments the respondents cared to make. The questionnaire was pretested on a representative convenience sample of 20 registered nurse tutors and was also TABLE 2: AGE DISTRIBUTION OF REGISTERED NURSE TUTORS scrutinised by a panel of experienced nurse EXPRESSED IN PERCENTAGE was considered to have content and face Age < 2 5 25-34 35-44 45-54 > 5 5 validity. teaching group 0,7 21 51 20 8 n = 142

Data collection non-teaching group — 17 37 28 18 The questionnaire together with a covering n = 91 letter requesting the nurse tutors total group 0,4 19,7 45,5 22,7 11.6 participation in the study and guaranteeing n = 233 anonymity and confidentiality, and a self- addressed stamped envelope was mailed to each of the 451 registered nurse tutors selected for the sample during October 1983. During December 1983 reminders TABLE 3: MARITAL STATUS AND DEPENDANTS OF REGISTERED were sent to sample members. By January NURSED TUTORS EXPRESSED IN PERCENTAGE 10, 1984, 255 questionnaires of which 233 Never Now Previously 1 or more were usable had been returned. married married married dependants Teaching group 31 55 13 A nalysis of data 68 n = 142 Each of the 233 completed usable Non-teaching group 30 52 12 59 questionnaires was edited and coded. Data n = 91 were organised and categorised, frequency counts were done and percentages of Total group 33 56 13 65 multiple choice answers were calculated. n = 233 From this analysis the following profile of ,

Vol. 11, No. 1 following a degree course. Of the total higher degree, 24 percent in nursing and 14 TABLE 4: TYPE OF NURSING group only 61 (26,2%) were graduates at percent in another field, while 9 percent PROGRAMME COMPLETED FOR the time they registered as a tutor, 45 had completed a diploma, certificate or REGISTRATION AS A NURSE, n = 233 (19,3%) held one degree and 16 (6,9%) two single subjects, 4,3 percent in nursing and 3 degrees, while 172 (73,8%) had received Programme n percent in another field. The remaining 1,7 both basic and post-basic qualifications at percent did not specify the nature of their SANC Diploma 195 83,7 diploma level. further study. The registered nurse tutor Bachelors degree 29 12,4 Seventy-seven percent of the registered with a diploma as highest qualification still O th e r 7 3,0 nurse tutors under study had completed remains in the majority (52%). U n k n o w n 2 their tutor studies on a full-time basis and Of the 14 percent of nurse tutors who T o ta l 233 99,9 had obtained substantial financial had completed degrees in another field assistance towards their studies from than nursing 3,4% had completed a BA employing authorities. For the majority of degree, 3,4% a B.Soc. Science, 0,8% a the group this included study leave on full B.Admin., 0,4% a B.Sc., 1,2% a B.A. Hons Type o f basic nursing programme pay and payment of all tuition fees. Of the (Psychology), 1,2% a B.A. Hons completed fo r registration as a nurse remaining 23 percent who had undertaken Sociology, 1,2% an M.A. Sociology and The greater majority of registered nurse their tutor studies on a part-time basis, 0,8% an M.A. Psychology, 0,8% D.Ed. tutors have completed their basic nursing slightly less than two-thirds (61,5%) had and 0.4% a Ph.D. programnme at diploma level. Of this completed their study through UNISA. All A number of registered nurse tutors group of respondents 195 (83,7%) have respondents who had obtained their nurse were still engaged in studies towards a completed the SANC diploma and 7 tutor qualification through degree studies bachelors or higher degree at the time of (3,0%) other diploma or certificate or by means of single subjects had studied the survey. The greater majority (21,4%) programmes, bringing the total number of part-time, while all respondents holding were studying towards a bachelors degree tutors with a non-degree basic nursing diploma qualifications, with the exception while 6,4, 4,2 and 3 percent respectively lification to 202 (86,7%). The other of 4, who had completed their studies were studying at Honours, Masters and fgrammes include Medical Council through UNISA had studied full-time. doctoral level. certificates, which had been obtained Only ten percent of the total group The projected percentage of registered before the days of the SANC, a University financed themselves for their tutor nurse tutors holding a bachelors degree as diploma and Certificates obtained qualification. minimum academic qualification should overseas. All but 0,9% of the respondents have, therefore increase to 69,4 percent when obtained their tutor qualifications in this those tutors who are currently studying Type or programme completed to first co u n try . towards first bachelors degree complete register as nurse tutor and basis on which their studies (at the time of publication of tutor studies were undertaken Participation in continuing formal this report, this should already have Almost four-fifths of the group (79,4%) education materialised). followed the University diploma Less than one-half of the registered nurse A variety of factors prevented more than programme leading to nurse tutor tutors (47%) had availed themselves of half (53%) of the registered nurse tutors registration, while 31 (13,3%) obtained existing opportunities to further their from continuing with further formal their tutor registration with a post- studies in either nursing education or studies, the most important (frequent) ones registration bachelors degree. 8 (3,4%) with another field, after completion of their that were cited were a too heavy workload a masters degree and a further 8 (3,4%) by studies to register as a tutor. Thirty-eight and family responsibiUties. means of additional single subjects percent had completed a bachelors or Additional post-registration courses From Table 7 it is noted that less than one- quarter of the registered nurse tutors TABLE 5: TYPE OF PROGRAMME COMPLETED TO FIRST REGISTER AS A (20,2%) have not followed an additional NURSE TUTOR post-registration course in nursing, while Graduates Non-graduates Totalgroup 76 percent have completed at least one Program m e n % n % n % post-registration course in addition to the University Diploma 14 48,2 171 84,2 185 79,4 tutor course. Post-registration Nursing administration appears to be bachelors degree 8 27,2 23 11,3 31 13,3 the most popular course, followed by Masters degree 7 24,1 1 0,4 8 3,4 Community Health with 48 percent Additional single holding the former qualification and 47 subjects 8 3,9 8 3,4 percent the latter. Advanced Clinical U n k n o w n — ——— 1 0,4 certificates representing a variety of T o ta l 29 203 99,8 233 99,9 nursing specialties are held by 16,6 percent of tutors. Nursing Specialties in which these certificates have been obtained are in rank-order from most to least; operating

TABLE 6: A COMPARISON OF HIGHEST ACADEMIC QUALIFICATIONS OF REGISTERED NURSE TUTORS AT TIME OF REGISTRATION AS TUTOR AND AT TIME OF SURVEY (JANUARY 1984) n = 233 TABLE 7: NUMBER OF ADDITIONAL At time of registration Since registration as POST-REGISTRATION COURSES as tutor tutor at time of survey COMPLETED REGISTERED NURSE Qualification n % n % TUTORS (n = 233) Post-registration tutor Number of Respondent D ip lo m a 185 79,4 121 52,0 post-registration courses n ? Bachelors degree 39 16,0 75 32,0 N one 47 20,2 Honours degree —— 15 6,4 O ne 88 37,8 Masters degree 8 3,4 16 6,8 T w o 75 32,2 D o c to ra te —— 6 2,6 Three or more 15 6,4 U n k n o w n 1 0,4 — — Unknown 8 3,4

Vol. 11, No. 1 theatre, paediatrics, orthopaedics, intensive (4,7%) have taught at a technicon, in in- dissimilar in others by gender, age, marital care nursing, advanced midwifery and service education programmes or status, population group, place of neonatology, advanced psychiatric nursing paramedicals. employment, posts held, educational and and advanced clinical care. professional background and experience. Place o f employment and posts held Unlike the pre 1980’s when the nurse PROFESSIONAL BACKGROUND One-third of the registered nurse tutors are tutor population was exclusively female, AND EXPERIENCE employed in nursing colleges, 32 percent in the registered nurse tutor population of the These data include years of clinical nursing hospitals, 11 percent in universities and 1980’s is no longer exclusively sex-linked. experience positions held in the clinical technicons and almost one-quarter in a A small percentage of males have availed field, teaching experience, place of one wide variety of other fields, including the themselves of the opportunity to qualify as employment and post held, time spent on Head Offices of Provincial and State tutors and have thus joined the ranks of teaching and enactment of scholarly role. Hospital and Health Services respectively. the nurse tutor population. The important Local Authority areas. Old Age Homes, implication of this is that men can now Clinical nursing experience o f registered Community Health Services, Industry and also add their own critical, rational and tutors Commerce. empirical interest to nursing education, a As indicated in Table 8 the number of Of the registered nurse tutors in teaching contribution which may be considered registered nurse tutors with limited clinical posts, slightly more than one-third hold conducive for a changing profession in a experience is small. Not even 20 percent senior positions such as professor (2%) changing society with a need for a diversity had two or less years of clinical nursing principal of nursing colleges (7%), senior of interests. experience when registering as a tutor, lecturer (3%) and senior tutor (25%). The The majority of tutors were found to be while 80 percent had more than three years registered nurse tutors in non-teaching chronologically mature women, with and 61,8 percent more than five years of posts are found in a great variety of posts, considerable experience. (The median age experience in the clinical field. ranging from Director and Deputy- is 43,1 years). This should enable them to Director of nursing, chief and senior cope with the demands of the time. As nursing service manager to professional almost two thirds of the tutors are marry officers, ward sisters and researchers. and/or with dependants, it can be assun TABLE 8: YEARS OF CLINICAL that the majority of nurse tutors occupy at EXPERIENCE BEFORE REGISTERING Time spent on teaching and teaching- least two very demanding roles, housewife AS A TUTOR related activities and careerwoman, a development which Years of experience n % With the exception of two percent of employing authorities and the profession < I year 5 2,1 registered nurse tutors in teaching posts, have virtually ignored, but which I -2 years 41 17,6 all tutors in teaching posts appear to spend undoubtedly holds several implications for 3 -4 years 43 18,5 far more than 40 hours a week on teaching nursing education particularly with regard 5 years and more 144 61,8 and teaching-related activities. The time to continuing education and the scholarly spent on specific activities varies according role. More than two-fifths of the to work situation and rank. For the respondents cited family responsibilities majority of nurse teachers, classroom and workload as major deterrent to Fields o f experience teaching is a major activity. More than continuing education. This finding is The nature of the clinical experience one-quarter (26,5%) of the College tutors similar to those cited by Kretch et al. obtained is typically in a variety of areas. spend more than 20 hours a week on (1962: 496) that women who occupy the Seventy percent have gained experience in classroom teaching, while 45,2 percent position of housewife and career woman both medical and surgical areas and spend between 11 - 20 hours a week on this frequently experience trouble and are another 30 percent in specialised branches activity. Considerable time is also spent on unable to meet the status expectations of of these fields. Twenty percent have had individualised teaching, counselling, both roles. Because of the small percentage experience in nursing administration and 9 preparing lessons, setting and marking of single women in senior posts in the percent as clinical teachers, while only 14 tests and examinations and administrative health services to-day, the services are not percent have had experience as community activities. Only one-quarter of the College able to cope without the married woman. health or psychiatric nurses. tutors spend some time each week on Authorities and leaders thus need to clinical teaching and clinical assessment become sensitive to the loads carried b y ^ ^ Positions held in the clinical field and almost two-third (65,3%) spend less many of their staff members and institute Fifty five percent of the registered nurse than 1 hour per week in visiting wards or plans to give the necessary support to tutors held relatively senior positions in the community health facilities, while the those who may need it, so that they may be services, ranging from senior sister to remaining one third spend less than 5 enabled to continue with the necessary senior matron before doing the tutors hours per week on this activity. studies. Continuing education is not only course. Only 1,3% had had no clinical an individual and social responsibility of a experience as registered nurse, while the professional in contemporary society, but a Enactment o f scholarly role remaining 43,7 percent had held sisters sine qua non. It is mainly through posts before becoming tutors. As so much time is spent on teaching continuing education that the tutor activities, very little time is left for becomes aware of her scholarly role, a Teaching experience since tutor professional development and scholarly requisite for tertiary educators, but which registration activity. More than 80 percent of College as the findings reveal, is still very tutors spend less than 5 hours a week and A very small group (7,7 percent) has not neglected. almost 20 percent less than 1 hour a week had any teaching experience at all since The fiflding that not even two-fifths of on professional reading, while over 95 qualifying as a tutor. Included in this the respondents had at least a matri­ percent spend less than one hour a week group are matrons, sisters in general culation background in mathematics or on research or writing. nursing areas, and in child psychiatry and science is a matter of concern, as many of housewives. Almost one-half of the group the intricate modern technological devices (46,3%) taught for five years or longer, Discussion and data which nurses are exposed to to­ while more than one-third (37,7%) has had From the findings it has become clear that day, are difficult to understand and 1 -4 years of teaching experience. the registered nurse tutor population of the explain without the use of mathematical The greater majority of tutors (76,7%) 1980’s is a very heterogeneous population. concepts. An ability to calculate and have taught pre-registration students in The individual nurse tutor cannot there­ communicate mathematical and scientific hospital and college setting while one-half fore be represented by a stereotyped information with accuracy is essential. have also taught pupil nurses in hospital description of the registered nurse tutor. Efforts should therefore be made to offer and College setting, and 15 percent nursing Among the population some were like appropriate relevant remediation to those students at a university. A small group their counterparts in some respects and who may require it, or otherwise to

Vol. II, No. 1 organise the programme in such a way that towards one. If this trend is continued, the the findings more credible. The findings tutors with insufficient mathematical gap should be closed in due time. may thus be regarded as an approximate background be placed in areas of teaching Judging from the profile identified with data base of the total registered nurse tutor where a mathematical background is not this study, there is no reason to believe population in the RSA during 1984. req u ired . that the contemporary nurse tutors cannot The concern of nurse leaders that nurse meet the challenge of tomorrow provided tutors have too limited a clinical of course that they are given the time, a Acknowledgement experience was partially disproved, as conducive climate and co-operatiion. In conclusion I wish to acknowledge the eighty percent of respondents had had financial assistance received from the Human more than three years of clinical Limitations Sciences Research Council in this study. experience before registering as a tutor. Even though every effort was made in the This experience had been gained in many design and conduct of the study to obtain BIBLIOGRAPHY different fields. On the other hand, the not only a random sample, but also a Brink, H. 1984. The registered nurse tutor in the concern that the contemporary nurse tutor proportional stratified one to be RSA. Doctoral thesis, UNISA: Pretoria. may not be maintaining sufficient contact representative of the total population as Harrison, P.H. 1979. Salute to some nursing with the practical realities of the clinical far as sex and population group was pioneers. Curationis, vol. 2, no. 2: 53-55. situation, was partially justified, as only concerned, certain weaknesses in the study In Memoriam, 1973. Miss Mary G. Milne, first one-quarter of the respondents spent some are apparent. As an example, the low sister tutor in South Africa. SA Nursing time each week in the clinical field, while response rate (51,5 percent of usable Journal, vol. XL, no. 4: 13. almost two-thirds spent less than one hour questionnaires) could have biased some of Krech, D. Crutchfield, R.S., Ballachey, E.L. a week visiting clinical facilities. the findings. It may be assumed for 1962. Individual in Society. New York: The time factor appeared to be largely instance that a greater proportion of tutors McGraw-Hill. Miss 1.1. Marwick leaves South Africa. 1968. responsible for this, and also the in possession of a degree as highest Nursing Journal, vol. XXXV, no. 7: 25. organisation of the work schedule. qualification than a diploma as highest Searle, C. 1964(a). Testimony to fifty years of tention needs to be given to this qualification responded. This could have service. Pretoria: SANA. lation and possible contributory factors skewed the results toward a higher Searle, C. 1964 (b). The history o f the • need to be identified and rectified. As far percentage of degreed people than there development o f nursing in South Africa, as her colleagues in other tertiary actually are in the total population. If this 1652-1960, Cape Town: Struik. education institutions are concerned, it was the case it may also have influenced appeals as though the nurse tutor of the findings relating to aspects such as the 1980’s has lagged behind, with regard to scholarly role and other professional and This article is based on part of the research undertaken in 1983 for the degree D.Litt. et qualifications. A degree is a requirement educational experiences. Therefore the Phil, with the University of South Africa. for all colleagues in tertiary education findings of this study cannot be considered posts. A considerable proportion of nurse absolutely conclusive or representative of tutors do not yet possess degrees. The the total tutor population. On the other findings however indicate that even though hand the results obtained from an analysis H 1 L Brink, D.Litt. et Phil., RN RM at the time of this study, only 47 percent of of a further 21 questionnaires, which were RT RNA Rc HN, Professor the respondents held at least a bachelors received too late to be included in this Dept, of Nursing Science, UNISA degree, another 22 percent were studying study, revealed a similar trend. This makes

Vol. 11, No. 1