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AN INVESTIGATION OF ANTI-INTELLECTUALISM AMONG

NURSES
Jamie Davis-Tubbs

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AN INVESTIGATION OF ANTI-INTELLECTUALISM AMONG NURSES

by

Jamie Davis-Tubbs

A Dissertation
Submitted to the Graduate School,
the College of Nursing and Health Professions
and the School of Leadership and Advanced Nursing Practice
at The University of Southern Mississippi
in Partial Fulfillment of the Requirements
for the Degree of Doctor of Philosophy

Approved by:

Dr. Lachel Story, Committee Chair

Dr. Marti Jordan
Dr. Hwanseok Choi
Dr. Elise Juergens

August 2022
 COPYRIGHT BY

Jamie Davis-Tubbs

2022

Published by the Graduate School

 ABSTRACT

Anti-intellectualism is often offered as an explanation for irrational actions,

especially in the grips of uncertainty. The effects of the COVID-19 pandemic have

uncovered the consequences of anti-intellectualism within the healthcare system. Nurses,

the most identifiability trusted healthcare professionals, have been used to illustrate a

healthcare paradox regarding COVID-19. The healthcare paradox presents nurses as

highly trained healthcare professionals who do not believe in their own science and reject

scientific expertise. Furthermore, nursing anti-intellectualism has been used to spread

misinformation during a major health crisis. Yet, we do not know the depth in which anti-

intellectualism exists within the nursing profession. Very little empirical research has

been done on anti-intellectualism with even less scholarly work done within the nursing

profession.

Therefore, the purpose of this study was to determine the depth in which anti-

intellectualism exists among a group of practicing nurses, and if relationships and

predictors exist between intrinsic factors, pertaining to demographic variables, and anti-

intellectualism. The quantitative study utilized a descriptive, correlational design based

on Hofstadter’s (1963) work on anti-intellectualism. Demographic data and anti-

intellectualism levels, quantified by an Intellect-Anti-Intellectualism Scale (IAIS), were

collected through 639 online surveys. The study population included American nurses,

who have practiced within the past two years, after completing all requirements for

licensure. Nurses were recruited through various social media sites over a 6-week period,

and data were analyzed using descriptive, correlational, and regression statistics methods.

Statistical tests included frequencies, cross tabulation, bivariate analyses, and binary

ii
logistics regression analyses, which were performed to identify independent variables on

the dependent variable, anti-intellectualism. Quantitative data identified the existence of

anti-intellectualism among a group of practicing nursing and correlations between anti-

intellectualism and (a) age, (b) U. S. location, (c) additional non-nursing degrees, (d)

religiosity, (e) political party affiliation, and (f) information obtainment for healthcare

trends. The findings are significant regarding nursing anti-intellectualism and provide

insight into the existence of anti-intellectualism within the nursing profession.

iii
 ACKNOWLEDGMENTS

Special thanks to Dr. Lachel Story, who was always very supportive and

encouraging. You are a percipient leader and mentor. To the rest of my committee

members, you are wonderful. I am grateful to you all. Dr. Elise Juergens, you are a sage.

Dr. Hwanseok Choi, you always have a resource ready and available. Dr. Marti Jordan,

you are always au courant with your knowledge and have your fingers on nursing’s pulse.

To my coworkers, thank you for all your contributions; your support made this work

possible.

iv
 DEDICATION

To my spouse, you are the best partner I could ask for. Through this experience, I

have realized how rare and admirable of a person you are, and I am thankful for all your

big brain full of wisdom and guidance. This entire process would not have happened

without you.

To my children, the three coolest kids I know, my life is better because of you.

Though you probably were not fully aware of what I have been doing all these years, I

am so grateful for your sacrifice, patience, and understanding during this process. You

have brought joy during the tough moments and always fill me with pride.

v
 TABLE OF CONTENTS

ABSTRACT........................................................................................................................ ii

ACKNOWLEDGMENTS ................................................................................................. iv

DEDICATION .................................................................................................................... v

LIST OF TABLES ............................................................................................................. xi

LIST OF ILLUSTRATIONS ............................................................................................ xii

LIST OF ABBREVIATIONS .......................................................................................... xiii

CHAPTER I – RESEARCH PROBLEM ......................................................................... 15

Introduction ................................................................................................................... 15

Problem Statement ........................................................................................................ 16

Research Question ........................................................................................................ 18

Purpose.......................................................................................................................... 19

Theoretical Framework ................................................................................................. 20

Operational Definitions ................................................................................................. 27

Anti-Intellectualism .................................................................................................. 27

Nurse ......................................................................................................................... 28

Nursing Anti-Intellectualism .................................................................................... 28

Demographics ........................................................................................................... 28

Assumptions and Limitations ....................................................................................... 30

Significance................................................................................................................... 31
vi
 Summary ....................................................................................................................... 35

CHAPTER II – REVIEW OF LITERATURE ................................................................. 36

Introduction ................................................................................................................... 36

Search Strategies ........................................................................................................... 37

Analysis of Anti-Intellectualism ................................................................................... 39

Empirical Literature ...................................................................................................... 42

Nursing Literature ......................................................................................................... 48

Anti-Elitism............................................................................................................... 49

Practicality ................................................................................................................ 51

Anti-Rationalism ....................................................................................................... 55

Democratization of Intellect ..................................................................................... 56

Nursing degrees and licensure .......................................................................... 57

Nursing Education. ........................................................................................... 58

Summary ....................................................................................................................... 65

CHAPTER III - METHODOLOGY ................................................................................. 67

Introduction ................................................................................................................... 67

Research Design............................................................................................................ 67

Setting and Sample ....................................................................................................... 69

Sample....................................................................................................................... 69

Sample Size. .............................................................................................................. 70

vii
 Setting ....................................................................................................................... 71

Instrumentation and Materials ...................................................................................... 75

Validity and Reliability ................................................................................................. 78

Validity ..................................................................................................................... 78

Reliability.................................................................................................................. 80

Procedure ...................................................................................................................... 80

Data Analysis ................................................................................................................ 82

Hypothesis..................................................................................................................... 85

Ethical Considerations .................................................................................................. 85

Summary ....................................................................................................................... 86

CHAPTER IV – RESULTS .............................................................................................. 88

Introduction ................................................................................................................... 88

Descriptive Data............................................................................................................ 89

Demographic Data .................................................................................................... 89

IAIS data ................................................................................................................... 97

Correlational Data ....................................................................................................... 102

Spearman’s Rho ...................................................................................................... 102

Logistic Regression ................................................................................................. 103

Age. ..................................................................................................................... 104

Location. ............................................................................................................. 105

viii
 Non-Nursing Degrees ......................................................................................... 105

Primary Source for Health Care Trends That Affect Practice ............................ 106

Political Party Affiliation. ................................................................................... 106

Summary ..................................................................................................................... 108

CHAPTER V – CONCLUSION .................................................................................... 109

Introduction ................................................................................................................. 109

Discussion ................................................................................................................... 110

RQ1: To what degree does anti-intellectualism exist in a group of practicing nurses?

................................................................................................................................. 110

RQ2: Are there significant relationships between demographic variables that

correlated................................................................................................................. 112

with anti-intellectualism among a group of practicing nurses? .............................. 112

RQ3: Which demographic data variables indicate a likelihood of anti- ................. 115

intellectualism among practicing nurses ................................................................. 115

Limitations .................................................................................................................. 120

Recommendations for Practice and Education ........................................................... 121

Recommendations for Research ................................................................................. 123

Conclusion .................................................................................................................. 123

APPENDIX A – Intellectualism-Anti-Intellectualism Scale (IAIS) ............................... 125

APPENDIX B – Demographic Questionnaire ................................................................ 127

ix
APPENDIX C – IRB Approval Letter ............................................................................ 132

APPENDIX D – Recruitment Flyer ................................................................................ 133

APPENDIX E – Modified Recruitment Flyer for Instagram and Twitter ...................... 134

APPENDIX F – Additional Modified Recruitment Flyer for Facebook and LinkedIn .. 135

APPENDIX G – Image of Inclusion Criteria from Qualtrics Survey ............................. 136

APPENDIX H – Informed of True Research Intentions (Image from Qualtrics Survey)

......................................................................................................................................... 137

REFERENCES ............................................................................................................... 138

x
 LIST OF TABLES

Table 1 Operational Definition for Demographic Variables ............................................ 29

Table 2 Demographic Variables ....................................................................................... 69

Table 3 Descriptive Statistics of Demographic Variables ................................................ 92

Table 4 Descriptive Statistics of Intellectual Anti-intellectual Scores (IAIS) .................. 99

Table 5 Cross tabulation of IAIS Categories and Demographic Variables .................... 101

Table 6 Single Item Logistic Regression Analysis (Predictive Items) ........................... 107

xi
 LIST OF ILLUSTRATIONS

Figure 1. Histogram of Total IAIS Scores. ....................................................................... 99

xii
 LIST OF ABBREVIATIONS

AACN American Association of Critical-Care

Nurses

AANP American Association of Nurse

Practitioners

ADN Associates of Nursing Degree

ANA American Nurses Association

APRN Advanced Practicing Nurse

BSN Bachelor of Science in Nursing

CDC Centers for Disease Control and Prevention

CINAHL Cumulative Index to Nursing and Allied

Health Literature

DNAP Doctor of Nursing Anesthesia Practice

DNP Doctor of Nursing Practice

EBSCOhost Elton B. Stephens Company

IAIS Intellect-Anti-Intellectualism Scale

IRB Institutional Review Board

LPN Licensed Practical Nurse

LVP Licensed Vocational Nurse

MSN Master of Science in Nursing

NCSBN National Council of State Boards of

Nursing

NSCG National Survey of College Graduates

xiii
PEO Population, Exposure, and Outcome

PhD Doctor of Philosophy

PN Practical Nurse

PRN Pro re nata

RN Registered Nurse

SAIS Student Anti-Intellectualism Scale

SPSS Statistical Package for the Social Sciences

USM The University of Southern Mississippi

U.S. United States

xiv
 CHAPTER I – RESEARCH PROBLEM

Introduction

Anti-intellectualism is a term that is often found in politics and religion; however,

it has seeped its way into other major aspects of American life. Anti-intellectualism is not

a lack of intelligence but the minimization of intellectual value (Hofstadter, 1963). Anti-

intellectualism is influenced by the social constructs of American society, and the social

constructs of health are not immune from the anti-intellectual virus. The healthcare

system is riddled with anti-intellectual ideas and practices.

In recent years, the term, anti-intellectualism, has begun to crop up in nursing

research. However, the conversation is often unhelpfully vague. The research addresses

anti-intellectualism in one of two ways—anti-intellectualism is seen as an insidious,

amorphous idea discussed conceptually, or is discussed as a problem or an unidentified

phenomenon with examples of anti-intellectualism.

Nursing researchers have analyzed the presence of anti-intellectualism within

nursing education, but, to date, nursing scholars have not collected meaningful empirical

evidence. One, non-nursing, quantitative study has identified high levels of anti-

intellectualism among nursing students (Laverghetta & Nash, 2010). According to the

literature review, discussed in-depth within Chapter II, a fair amount of evidence exists

indicating the presence of anti-intellectualism and shared risk factors for anti-

intellectualism within the nursing profession. These shared anti-intellectual risk factors

are both rooted in the history of nursing education and the profession but are also seen in

modern nursing.

15
 Problem Statement

Anti-intellectualism is generally defined as the distrust and skepticism of

intellectual development by field experts. The pairing of nursing, a scientifically based

field of study, and anti-intellectualism, commonly associated with the depreciation of

science, seems incongruous. However, as COVID-19 vaccine mandates began to take

effect for healthcare workers, nurses have made headlines. These headlines put a

spotlight on nursing anti-intellectualism as American nurses reported their willingness to

lose their jobs over individual liberties, political affiliations, and conspiracy theories.

According to the media, approximately 69% of health care workers, which

includes nurses, are vaccinated in Louisiana's largest hospital system (WDSU Digital

Team, 2021). In Virginia and Michigan, healthcare workers, mostly nurses, protested

vaccine mandates (Al-Arshan, 2021). According to a representative of the Ohio Nurses

Association, roughly 30% of nurses in the Cincinnati area are willing to quit their jobs

due to vaccine mandates (Al-Arshan, 2021; Bella, 2021; DeMio, 2021). Data is limited

on the number of nurses who will lose their jobs for not complying with vaccine

mandates, as vaccine mandates have become overlooked or pushed back to the spring

months of 2022. However, according to the Chicago Sun, Advocate Aurora Health, a

Midwestern hospital system, has fired over 400 employees, the highest number of

workers reported to date, for being unvaccinated (Chase & Dey, 2021). Another hospital,

in North Carolina, has fired 175 healthcare workers and suspended 375 employees (Al-

Arshan, 2021; Bella, 2021). The number of nurses within this group of healthcare

workers is unknown. However, nurses are quoted in these news sources expressing their

16
willingness to leave their current positions due to the vaccine mandates placed by

employers (Al-Arshan, 2021; Bella, 2021).

As the vaccine mandates have begun to play out, legislatures and professional

organizations have reacted. Organizations, including the American Association of

Critical-Care Nurses (AACN, 2021), the American Nurses Association (ANA, 2021a),

and the New York State Nurses Association (NYSNA, 2021), have published position

statements unequivocally supporting COVID-19 vaccinations and dismissing frivolous

exemption claims. Various nursing state boards have begun the process of sanctioning

unvaccinated nurses, who refuse to receive the COVID-19 vaccinations (Botkins, 2021;

Hollingsworth, 2022). However, the vaccination positions of hospitals and nursing

organizations have largely become moot due to critical staffing shortages (Whelan &

Evans, 2021). The repercussions of this conflict are pervasive. Nurses who refuse to

comply with hospital policies regarding COVID-19 are often the focus of media

attention, where they are given a national platform with which to spread misinformation

(Rahman, 2021). Consequently, the tone and substance of policy and position statements,

from the National Council of State Boards of Nursing (NCSBN, 2021b, 2021c) have

shifted to focus on the dangers of said misinformation and the professional obligations of

nurses to prevent its spread.

The media’s attention on the nursing profession’s anti-intellectualism has created

an avenue for harmful propaganda, ultimately, putting the profession in an unfavorable

light. Additionally, the nursing profession’s gravitas has become a target for anti-

intellectual actors. These anti-intellectual actors use the nursing profession and cite these

public displays of nursing anti-intellectualism, to validate their own anti-intellectual ideas

17
and further spread anti-intellectual rhetoric. News articles are pointing to nurses’ social

media accounts as evidence of nursing anti-intellectualism over COVID-19 vaccinations

and masking (Corrigan, 2021: Hauser, 2020)

Nursing pedagogy emphasizes evidence in the form of the scientific method and

facilitates clinical reasoning skills based on the scientific process. Yet, practicing nurses’

willingness to deny the science and lose their jobs as a consequence appears counter-

intuitive, leading one to question their credibility. The nurses featured in these articles

may or may not be outliers of the profession, but it remains unknown how deep the anti-

intellectual sentiments run among nursing professionals. However, evidence in the

research suggests that nursing students have high levels of anti-intellectualism though it

is undetermined if this mindset is perpetuated by nursing education, nursing practice, or

some other intrinsic factors. A gap in the available research has been identified regarding

the existence of anti-intellectualism among practicing nurses from an empirical

perspective. Therefore, the research aims of this study are to determine the degree of anti-

intellectualism among a group of practicing nurses and the intrinsic factors that these

nurses share. Additionally, this research hopes to gain insight into the intrinsic factors

that influence anti-intellectualism among practicing nurses.

Research Question

The research questions for this study are:

RQ1: To what degree does anti-intellectualism exist in a group of practicing nurses?

RQ2: Are there significant relationships between demographic variables that correlated

with anti-intellectualism among a group of practicing nurses?

18
RQ3: Which demographic data variables indicate a likelihood of anti-

intellectualism among practicing nurses?

Purpose

The purpose of this study was to investigate the (a) degree of anti-intellectualism

among a group of practicing, American nurses; (b) the demographic data, or intrinsic

factors, practicing nurses possess, that correlate with anti-intellectualism, and (c)

determine intrinsic factors that indicate a likelihood of anti-intellectualism among

practicing nurses. Due to the lack of empirical evidence for anti-intellectualism among

nurses, the study was quantitative. The study was rooted in descriptive, correlational

research, and collected data using an anti-intellectual scale to determine the depth to

which anti-intellectualism exists among practicing nurses. This study focused on

practicing nurses who have completed their initial nursing education and have practiced

within the past two years. Targeting practicing nursing for this research provided more

insight into the inherent factors or commonalities at play.

Additionally, the study hoped to gain insight into any intrinsic factors that

influence anti-intellectualism in nursing including the significance or correlations of

demographic data. To determine whether anti-intellectualism is a problem within the

nursing profession, the depth of and correlating factors associated with anti-

intellectualism need to be identified through quantitative means. Moreover, determining

factors that predict the risk of anti-intellectualism within the nursing profession helps the

profession determine a way to combat its existence. Demographic data along with a scale

that determines anti-intellectualism was collected. Participants were recruited through a

large social media harvest, and the data was collected through online surveys over a six-

19
week period (King et al., 2014; Stokes et al., 2019). The study hypothesized that a

significant level of anti-intellectualism would be identified and that significant

relationships between demographic data and anti-intellectualism exists. Additionally, the

study hypothesized that demographic variables pertaining to the education a nurse

received affect a nurse’s level of anti-intellectualism. Specific correlating factors for anti-

intellectualism among nurses, theorized from the theoretical framework and empirical

data, included political affiliations, religion, licensure for practice, and age. More details

regarding the methodology of this research will be discussed in Chapter III.

Theoretical Framework

The framework for the research is Richard Hofstadter’s (1963) analysis of anti-

intellectualism in his work Anti-intellectualism in American Life. Hofstadter’s analysis

contains the socio-epistemological and historical perspective of anti-intellectualism.

According to Eigenberger and Sealander (2001), Hofstadter’s publication was the first

scholastic analysis of anti-intellectualism from a sociological perspective. Further,

Hofstadter’s work is rooted in a sub-discipline of sociology regarding epistemology, also

known as the sociology of knowledge (Rigney, 1991).

The sociology of knowledge is the socio-cultural foundation for an individual’s

knowledge development (McCarthy, 2013; Wolff, 1974). Simply put, the sociology of

knowledge is the idea that an individual’s knowledge is contextual to social structures

like class, gender, ethnicity, religion, or culture, to name a few (McCarthy, 2013; Wolff,

1974). The sociology of knowledge is rooted in some of the sociological aspects of Karl

Marx’s, Max Weber’s, and Emile Durkheim’s early work; however, Karl Mannheim is

considered the founder (as cited in McCarthy, 2013; Wolff, 1974). Mannheim sharpened

20
the theoretical aspects of sociological knowledge by applying the social aspects of

Marx’s, Weber’s, and Durkheim’s work to create a holistic perspective (as cited in

McCarthy, 2013; Wolff, 1974). As sociological knowledge relates to Hofstadter’s (1963)

work, Hofstadter addresses specific social aspects that influence the perspective and

value of knowledge, and how those social aspects preserve anti-intellectualism.

As Hofstadter’s (1963) book traces the American history of intellectualism, he

points to the social influence of religion, politics, business (or practical culture), and

formal education as systems for perpetuating anti-intellectualism. Hofstadter (1963)

identified four key components of anti-intellectualism that are influenced by the

American social systems. These four components are anti-rationalism, anti-elitism,

practicality, and the democratization of intellect (Hofstadter, 1963).

Anti-rationalism, anti-elitism, and practicality are the forms of anti-intellectualism

that exist (Hofstadter, 1963). The democratization of intellect catalyzes anti-

intellectualism and is the vector by which anti-intellectualism is spread (Hofstadter,

1963). Hofstadter (1963) states that anti-intellectualism took power when intellects began

losing prominence in society. The first major influencing factor that antiquated the

downfall of the intellect was American religious influences (Hofstadter, 1963).

According to Hofstadter (1963), the evolution of the American Protestant religion

shaped the first form of anti-intellectualism via anti-rationalism. Anti-rationalism is not

defined as philosophical anti-rationalism, but as a thought process that is “gravely

inhibited”, waned, or uncultured (Hofstadter, 1963, p. 9). The popularity of the

evangelical spirit “diminished the role of rationality and learning” by promoting

emotional understanding and experiences, over methodical, scholarly reasoning

21
(Hofstadter, 1963, p. 55). Anti-rationalist views do not value and outright reject ideas that

contradict holy writs, therefore, placing limitations on intellectual development

(Hofstadter, 1963). The charismatic leaders of the Evangelical wave gained favor over

the formal clerical positions, traditionally composed of highly educated members that

valued education and enlightenment (Hofstadter, 1963). Ideology spread that any

follower of the faith could determine their own meaning of the Christian Bible, with the

rising popularity of the evangelical creed (Hofstadter, 1963). In turn, these ideas lead to

disregard and animosity toward those who had been trained to interpret the holy word

making them an easy target for rejection (Hofstadter, 1963).

Along with this sweeping religious influence, fear-mongering about modern

science was seen as a threat to the absolute truths of the faith (Hofstadter, 1963). The

potential loss of rural American traditions to industrialization was also used to maintain

followers (Hofstadter, 1963; Rigney, 1991). However, these methods encouraged anti-

rational thoughts rooted in fear and disdain for the staleness of rationalism, which led to

the first major wave of American anti-intellectualism. The spread of anti-intellectualism

through absolutions and fundamentalism, in the name of the evangelical spirit, began to

spill over into other aspects of American life and has become integrated into politics,

economics, and education.

As America modernized, the Christian creed was used to tackle new social

problems developed in government and economics as a means of “purify[ing] politics”

from power inequality (Hofstadter, 1963, p. 197). Similar in form to the intellectual

clergyman, the aristocratic politician became the next target for anti-intellectualism in the

form of anti-elitism. Anti-elitism refers to the rejection of “intellect represented as a form

22
of power or privilege” (Hofstadter, 1963, p. 34). Anti-elitism comes from a populist view

where the value of intellectual development is depleted by its association with privilege

(Hofstadter, 1963).

At the time anti-intellectualism began to gain traction, politics and other

hierarchical social structures were dominated by a group of elites, intellectual gentlemen.

The aristocratic gentleman, who had the luxury to become an intellectual, was viewed as

an out-of-touch elitist, and no longer had favor with the average person (Hofstadter,

1963). Eventually, “the rule of the patrician elite was supplanted by a popular

democracy,” yet suspension and disdain for this ruling class remained (Hofstadter, 1963,

p. 146). The demands of the new complexities of the American government increased the

desire for technocracy, which concluded the reign of the gentleman (Hofstadter, 1963).

The use of experts began to gain favor in society out of necessity; however, they still bore

the stain of mistrust and hostility from their predecessors—the American gentlemen

(Hofstadter, 1963). Hofstadter (1963) looks to politics as the most powerfully

disseminating vector for anti-intellectualism, though it heavily coincides with the

American capitalistic tendencies and the mythos of the self-made man.

The effect of the American business sector has “brought the anti-intellectual

movement more strength than any other force in society” (Hofstadter, 1963, p. 237). The

dueling aphorisms—the philosophical outlook of intellectualism and the practicing

class’s value for monetized labor, plays out in American economics. American capitalism

heavily fosters the production of anti-intellectual sentiments because of the system’s

inherent drive towards practical efficiency and propagation, and the internalization of the

rags-to-riches story (Hofstadter, 1963). American business culture elicits “dissonance

23
between business enterprise and intellectual enterprise” due to their “different sets of

values” (Hofstadter, 1963, p. 233). Immediate practical payoffs are deemed more

valuable than intellectual endeavors and theoretical education; and in this sense,

rationality is rewarded with capitalistic gain (Hofstadter, 1963).

The practical culture was also influenced by the popularity of the businessman

with his pragmatic and capitalist achievements (Hofstadter, 1963). The notoriety of the

businessman, with supposed rags-to-rich stories, were idolized for being self-made; in

actuality, they had the advantage of class, connection, and education (Hofstadter, 1963).

These practical business notions added to the years of budding resentment towards the

privileged, and the previously established American folklore that formal knowledge was

not always necessary for success (Hofstadter, 1963). However, the reality of the

American bootstrap myth is that the self-made businessman needs some educational

foundation to be successful. As Americans flocked to the bureaucratic business and

economic sectors of the workforce, universities met these workforce sectors’ demands for

formal education to integrate more vocational training (Hofstadter, 1963). Universities

began offering business degrees and other business-associated degrees like “engineering,

accountancy, economics, and law” (Hofstadter, 1963, p. 262). As higher educational

institutes moved from a liberal art focus to a more academically inclusive one, Hofstadter

(1963) recognized that this shift was the beginning step toward academic anti-

intellectualism.

Democratization of intellect is the utilitarian approach to education as a means of

equalizing members of a democratic society (Hofstadter, 1963). The democratization of

intellect is an equal opportunity for intellectual development through the American

24
education system (Hofstadter, 1963). Hofstadter (1963) views anti-intellectualism as a

negative byproduct of this democratization and looks to the American educational

systems for its perpetuation. According to Hofstadter (1963), anti-intellectualism exists in

American education through the three forms discussed above. Each political, religious,

and economic system has spread its own form of anti-intellectualism through the

democratization of intellect. By providing formal education to all members of society,

these forms influence intellectual development, and the value thereof (Hofstadter, 1963).

Though the idea of democratization of intellect is political in nature, the

educational quest for equal opportunity and universality, itself, is part of the integration

of religious morals. However, the notion of education for all was “not founded primarily

upon a passion for the development of the mind...but rather upon the supposed political

and economic benefits of an education” (Hofstadter, 1963, p. 305). The American

educational system was “in favor of certain notions of spontaneity, democracy, and

practicality” (Hofstadter, 1963, p. 362). The practical value placed on an educational

approach is based on the ability to “be measur[ed] by the number of immediate, actual

life situations to which it directly applies” (Hofstadter, 1963, p. 346). These ideals of

practicality and democracy trickled through the educational systems, and are found in the

higher educational, primary, and secondary systems, but the concept plays out across all

educational systems.

Higher education sets the standards for the lower educational systems by placing

obligations of academic rigor. The primary and secondary educational systems are

responsible for producing university-ready students. However, primary and secondary

educational systems also have the responsibility to meet the needs of all of those who are

25
served—all children who are legally required to attend school. The juxtaposition of these

two educational goals creates a conflicting academic system that cannot meet all the

needs of its students (Hofstadter, 1963). Therefore, educational systems create a one-size-

fits-all system that focuses on utility, and utility is measured through practicality and

democracy (Hofstadter, 1963). The integration of practicality and democracy manifested

into a focus on child-centered growth (Hofstadter, 1963). Child-centered growth

recognized that all students were not meant for scholastic achievement or would not meet

the meritocratic nature of higher education (Hofstadter, 1963). Child-centered growth

focuses on academic nurturing, which focuses on an individual’s intellectual capacities

and fostering self-improvement (Hofstadter, 1963). Hofstadter (1963) states that the

practical approach for this form of education is not bad, but it lacks rigorous standards for

intellectual development and leads to intellectual confinement.

Further, Hofstadter (1963) raises concerns about the influences of individual,

political, religious, and financial buy-in on the American education systems. The

educational system is a social institution that is directly influenced by the resources,

including financial incentives, provided by other social systems (Hofstadter, 1963). These

influencing social systems come with their own form of anti-intellectualism, and these

forms of anti-intellectualism migrate their way into the educational systems’ structure,

ideals, and outcomes (Hofstadter, 1963). Ultimately, the reliance of the educational

system on the religious, political, and business sectors of the American social systems

causes American education to become an agent of anti-intellectualism that feeds upon

itself (Hofstadter, 1963).

26
 Operational Definitions

These operational definitions were used to provide a clear understanding of the

terms utilized in this research. The following is a list of key elements addressed and

explored within this study. The operational definitions also include major concepts

addressed within the framework.

Anti-Intellectualism

Hofstadter (1963) discusses the concept of anti-intellectualism, in-depth, from a

political and psychosociological perspective. Hofstadter’s (1963) book does not

positively define anti-intellectualism, but instead, leaves the reader to understand that

anti-intellectualism is the foil of intellectualism, which he does define. Lacking a

concrete definition of such an important term, the trend, rooted in the literature, is to use

the following, “resentment of the life of the mind, and those who are considered to

represent it; and a disposition to constantly minimize the value of that life,” to describe

anti-intellectualism (Hofstadter, 1963, p. 7). Intellect differs from intelligence

(Hofstadter, 1963). Intellect was defined here as the “critical, creative, and contemplative

side of the mind” that is used for evaluation and meaning from a holistic perspective

(Hofstadter, 1963, p. 25). Intellect “theorizes, criticizes, and imagines[s]” (Hofstadter,

1963, p. 25). Where intelligence works to grasp concepts based on “immediate meaning

in a situation and evaluate it” through manipulation, and adjustment (Hofstadter, 1963, p.

25). Intellectualism and anti-intellectualism were measured with the intellectualism-anti-

intellectual scale (IAIS). The IAIS assesses variations in a person’s values for intellectual

interests (Marques et al., 2017). For this study, the operational definition for anti-

intellectualism and intellectualism were scores based on the IAIS, a 10-item Likert scale

27
questionnaire. Lower scores indicated anti-intellectualism, and higher scores indicated

intellectualism.

Nurse

A nurse is defined as any person who has graduated from an accredited nursing

school or program and has obtained licensure from the National Council of State Boards

of Nursing (NCSBN). The nursing profession is the collective of professional nurses who

specialize in the body of knowledge and skill sets pertaining to nursing practice.

Nursing Anti-Intellectualism

This research aimed to gain insight into nursing anti-intellectualism; therefore, a

definition of nursing anti-intellectualism is not clearly understood or defined. However,

the research operated under the following definition to begin the dissertation process.

Nursing anti-intellectualism is a licensed nurse who does not value or resent intellectual

development based on lower IAIS scores.

Demographics

Demographic variables were measured to determine intrinsic factors of nursing

anti-intellectualism. Demographics is data that describes a specific population. Intrinsic

factors are defining characteristics of an individual. The demographic variables and the

correlating operational definition are listed in Table 1.

28
Table 1

Operational Definition for Demographic Variables

Variable Operational Definition

Age Number of years alive
Gender identity Sense of self as male (0), female (1), non-binary (2), transgender (3),
preferred not to answer (4) *
Ethnicity Identified social groups based on race and culture as White or
Caucasian (0), Black or African American (1), American Indian or
Alaskan Native (2), Asian (3), Native Hawaiian or pacific islander (4),
Hispanic, Latino, or Spanish (5), multiple ethnicities (6)

Marital status Determinants of a legal union as single (never married) (0), married or
in a domestic partnership (1), widowed (2), divorced (3), separated (4)

Members of Household Number of people living in the home

Dollar amount of work-related pay $10,000 to 19,999 (0), $20,000 to

29,999 (1), $30,000 to 39,999 (2), $40,000 to 49,999 (3), $50,000 to
Income 59,999 (4), $60,000 to 69,999 (5), $70,000 to 79,999 (6), $80,000 to
89,999 (7), $90,000 to 99,999 (8), $100,000 to 149,999 (9), $150,000
to $ 199,999 (10), $ 200,000 or more (11)
Income affected by determine if income was increased by COVID-19 pay rates by yes (1),
Covid-19 or no (0)
Determine current employment state by a unit of measurement
equivalents full-time employment (0), part-time employment (1), PRN
Employment status or Per diem (2), traveler/contract employee (3), retired (4), student only
(5), self-employed (6), homemaker (7), unemployed looking for work
(8), unemployed not looking for work (9), unable to work or disable
(10)
Employment contracts Number of contracted employment jobs per year
Determine if the participant will leave or has left the workforce by yes
Leaving workforce
(1), or no (0)
Nursing licensure Type of nursing licensure as PN/LPN/LVN (0), RN (1), APRN (2)

Licensed Practice Certification (0), Diploma in Nursing Science (1),

Associate Degree in Nursing (2), Bachelor Degree in Nursing (3),
Master Degree in Nursing (4), Master Degree in Nursing – Nurse
Nursing Degree
Practice/Nurse Anesthesia (5), Doctorate of Nurse Practice (DNP) or
Doctorate of Nurse Anesthesia Practice (DNAP) (6) Doctor of
Philosophy in Nursing (7), Doctorate of Nursing Science (8)
Nursing specialties Type of nursing practice area or area of experience
Current enrollment in currently enrolled in a higher education program to obtain any
school additional degrees by yes (1), or no (0) and type of degree
Other degrees Type of non-nursing degree obtained from a high educational institute
health insurance reliance is contingent on the nursing job by yes (1), or
Health insurance
no (0)
Location/residency Geographical location category
29
Table 1 (continued).

determine the density of the population of the residential community by

Type of community rural area (0), small city or town (1), large city (2), suburb near a large
city (3)
Community determine involvement and contribution to social, residential setting by
involvement yes (1), or no (0)
Degree of community
Somewhat involved (0), moderately involve (1), very involved (2)
involvement
identify beliefs that pertain to public and governmental affairs
Political ideology associated with a U.S. social group of conservativisms (0), modernism
(1), liberalism (2)
membership of political party as Republican (0), Libertarian (1), Green
Political party
party (2), Constitutional party (3), Democratic (3), Independent (4), No
affiliation
party affiliation (5)
identify beliefs that pertain to the religious family of Asian Folk
Religious affiliation Religion (0), Hinduism (1), Judaism (2), Islam (3), Christianity, other
(4), or not religious (5)
Identify beliefs that pertain to the common U.S. sub-religions of
Christian religion Christianity including Baptist (0), Pentecostal (1), Methodist (2),
affiliation Anglican (3), Catholic (4), Presbyterian (5), Episcopalian (6), Lutheran
(7), non-denominational (8)
depth of religious beliefs not religious (0), slightly religious (1),
Religious level
moderately religious (2), very religious (3), don’t know (4)
Note: The demographic variables are measured by questions from a survey questionnaire. *(Centers for Disease Control and

Prevention [CDC], 2019, para. 8).

Assumptions and Limitations

The research assumed that anti-intellectualism exists within the nursing

profession. This research aimed to determine the degree of its existence and then provide

more insight into its character. Determining the degree of anti-intellectualism among

nurses was the first component of this research. If anti-intellectualism was not found to

be statistically significant, the other components of this research would become moot.

However, based on the extensive research on this topic in other disciplines, a likelihood

of anti-intellectualism does exist among practicing nurses.

Additionally, a common assumption among researchers is that all subjects are

truthful and forthright in their answers and identity. Online recruitment and surveys for

30
data collection create an added cloak of anonymity. Therefore, the lack of contact

between the researcher and the subject can create a lack of accountability and increase the

likelihood of false information.

The most significant limitation of this research is the effects of the COVID-19

pandemic on practicing nurses. According to Hofstadter (1963), “few intellectuals are

without moments of anti-intellectualism” (p. 21). This study hoped and assumed that the

burden of the current state of the healthcare systems and the exhaustion that nurses were

experiencing did not lead to nursing participants having momentary lapses in judgment

when completing the research survey. Furthermore, nurses who teeter the line or are

already burnt out from the pandemic are less likely to complete a survey about the

nursing profession as nurses are overwhelmed and exhausted, which can affect study

participation.

Lastly, this research assumes that the public display of anti-scientific ideas from

nurses is influenced by anti-intellectualism, not misinformation. Nurses are armed with

the tools to protect themselves from misinformation through nursing education. The

problem occurs when anti-intellectualism causes nurses to throw down these tools,

disarming themselves.

Significance

Anti-intellectualism affects nursing on a professional and individual level, and

nursing anti-intellectualism impacts those who interact with members of the profession.

Therefore, determining the depth of anti-intellectualism among nurses, and the intrinsic

factors associated with anti-intellectualism, provides insight into combating nursing anti-

intellectualism and its effects. Combating nursing anti-intellectualism is key to the

31
profession’s influence and future development, including those within the profession and

those which the profession affects.

Prevailing anti-intellectualism impedes the development of nursing as an

academic discipline. Questioning and disregarding the foundational knowledge of the

nursing profession indicates a lack of value for the intellectual development of the

profession. By undervaluing research and academic pursuit, limitations are placed on the

development of nursing knowledge. The generation of knowledge advances the

profession and legitimizes its academic relevance.

Not only does nursing anti-intellectualism affect the development of the nursing

profession but also the safety of practicing nurses. The science used to determine the

safety of health interventions is foundational to a nurse’s practice. Nurses who do not

value or deny scientific evidence in their own health care decisions create higher health

risks for themselves and those to which they provide care. Presently, the effects of anti-

intellectualism can jeopardize a nurse’s safety, as they choose to not protect themselves

from an infectious disease that has reached pandemic proportions.

According to the Centers for Disease Control and Prevention (CDC), as of July

2021, the percentage of nurses who were fully vaccinated is among the lowest of

healthcare providers (Lee et al., 2021). Vaccination coverages for nurses are

approximately 56.7% (Lee et al., 2021). Nursing vaccination coverage is lower than

physicians, advanced practice providers, therapists, and ancillary service employees (Lee

et al., 2021).

Additionally, the American Nurses Association (ANA, 2021b) conducted a

survey asking nurses if they would voluntarily get the COVID-19 vaccine. The ANA

32
(2021b) survey resulted in 36% of nurses saying “no” to voluntary COVID vaccinations,

and 31% indicating that they were “unsure”. The data by the CDC and ANA is

concerning, as nurses have the most patient contact and are the primary sources for

patient education (Lee et al., 2021; ANA, 2021b). Furthermore, the ANA (2021b) found

that 44% of nurses do not feel comfortable discussing the COVID-19 vaccine with

patients, though 70% feel knowledgeable about the vaccine. The ANA (2021b) survey

indicated that less than 50% of the nursing participants obtained COVID-19 vaccine

information from a reputable source, disclosing that 63% obtain their knowledge through

mainstream media, and 13% from social media (ANA, 2021b). The ANA (2021b) data

indicate a significant problem regarding the safety of those who receive care from nurses.

Without the vaccine and mask mandates, an unvaccinated, or unmasked, a nurse can

become a vector for spreading COVID-19 to their patients, family members, and the

public. The effect of nursing anti-intellectualism can be hazardous to society through the

nurse’s personal choices and professional influence.

As a profession, nursing influences society both within and outside of patient

care. Due to the sheer number of nurses in America, they are easily accessible by the

public and, typically, have the most contact with the public. According to the NCSBN

(2020), in the Fall of 2019, there are approximately 4,096,607 registered nurses, and

920,655 LPN/LVNs in the United States (NCSBN, 2020). The American Association of

Nurse Practitioners (AANP) (2020) indicates that there are approximately 325,000

licensed advanced practice registered nurses (APRNs). The view of nursing by the public

is generally very positive, and for nearly two decades, nurses have maintained the

highest-ranked profession in honesty and ethics (Saad, 2020). According to a Gallup poll,

33
the profession rose 4 percentage points from previous years, receiving the highest record

of public trust to date at 89% (Saad, 2020). The trust that nursing has developed with the

public creates a sense of connection; however, that trust can become compromised by the

spread of anti-intellectualism.

The public display of anti-intellectualism among nurses on both news and social

media platforms can spread anti-intellectual ideas among members of the profession.

Nurses publicly buying into conspiracy theories and advocating against the existence of

COVID-19, mandated masking, and COVID-19 vaccinations create a microcosm of

acceptable anti-intellectual beliefs that spread like a virus. The spread of anti-

intellectualism infects more members of the profession, it becomes transmitted to the

public. What cache nurses have accrued of honesty, trust, and credibility can directly

champion causes that lead to people dying. The nursing profession’s reputation allows for

public influence, and members of the public are likely to be swayed by the anti-

intellectual ideals of a nurse within their social circle. As with nursing practice, a nurse’s

influence can determine health outcomes, and in a pandemic, a nurse’s anti-intellectual

influences, outside of their practice, can become a matter of life or death. As some

members of society can become swayed by a nurse’s anti-intellectual ideas, others start to

question the integrity of the profession. Anti-intellectualism among nurses can damage

the rapport and trust that the nursing profession has developed with the public. If anti-

intellectualism continues to spread through the profession and continues to become

popularized through media outlets, nursing can suffer irreparable damage to its

reputation.

34
 Summary

Anti-intellectualism among nursing professionals is not fully understood.

Therefore, the goal of this study was to learn more information about anti-intellectualism

among practicing nurses. The literature discussed in Chapter II addresses anti-

intellectualism within nursing, but there is limited data currently available. The

prevalence and factors associated with anti-intellectualism among practicing nurses are

unknown. This study started with the foundation and attempted to determine the depth of

anti-intellectualism among nursing professionals and the factors associated with it.

Furthermore, to potentially combat the deterrents associated with anti-intellectualism, the

research looked at predictive intrinsic factors associated with anti-intellectualism. Being

able to predict anti-intellectualism as an outcome of the identified intrinsic factors will

better prepare and adequately educate stakeholders to intervene in the spread of anti-

intellectualism among nurses. The details of this research are described in the following

chapters. Chapter II, the literature review, discusses the understanding of the current

research, and Chapter III describes the methods used for this research. Chapter IV

describes the study’s results, and Chapter V discusses those results.

35
 CHAPTER II – REVIEW OF LITERATURE

Introduction

The literature review addresses anti-intellectualism associated with Hofstadter’s

analysis and anti-intellectualism within nursing. The review starts with the description of

Richard Hofstadter’s (1963) analysis of anti-intellectualism, in the book, Anti-

intellectualism in American Life. Hofstadter’s (1963) analysis serves as both a source and

the framework for this research. The qualitative and quantitative literature addressed in

this review is specific to the four major components of Hofstadter’s (1963) analysis. The

central tenets of Hofstadter’s (1963) analysis influence the categorization and synthesis

action of the literature pertaining to anti-intellectualism within the nursing profession.

The review is organized by methodology and thematic theory. The research questions and

methodology were influenced by the review of literature, along with the completion of a

theory substruction based on Hofstadter’s (1963) analysis.

Due to the nature and underpinnings of anti-intellectualism, most available

research focuses on theoretical development and is analytical in nature. The theoretical

research on anti-intellectualism overshadows the empirical. However, the empirical

evidence of the quantitative literature discusses outcomes that are generally the same.

The literature addresses quantitative data regarding anti-intellectualism, which included

uses and modifications of the instrument that was utilized in this research.

The literature review section starts with the theoretical framework for this

research. The sources for the review tapered in scope, ending with discussions of anti-

intellectualism within the nursing discipline. The review section focuses on nursing

research that addresses anti-intellectualism and its correlating concepts. Some of the

36
nursing research used the term anti-intellectualism, whereas other nursing articles address

the concept of anti-intellectualism without directly using the term. With the limited

availability of empirical data on anti-intellectualism in nursing, the discussed literature

pertaining to nursing is primarily theoretical and philosophical and is a mix of scholarly

opinions and analyses. The literature review is divided into the following sections:

research strategies, analysis of anti-intellectualism, empirical literature, nursing research,

and quantitative data regarding nursing anti-intellectualism.

Search Strategies

The research question for this dissertation does not pertain to intervention

effectiveness, but rather, to determining intrinsic factors, or exposures that lead to an

outcome – namely, the presence of anti-intellectualism in the field of nursing. The risk

for anti-intellectualism among practicing nurses is based on social influences and

education. Therefore, the research framework utilized for the dissertation is PEO, which

stands for population, exposure, and outcome (Doody & Bailey, 2016). The PEO strategy

focuses on a population’s exposure or developmental likelihood of an outcome (Doody &

Bailey, 2016). This framework was chosen to focus on (a) the nursing population; (b) the

nurses’ exposure to ideals of practicality, anti-elitism, and anti-rationalism within their

practice and in nursing education; and (c) the outcome of anti-intellectualism.

This literature review includes both journal and non-journal articles, books, and

some gray literature. Initial searches resulted in over 800 articles about Hofstadter’s

analysis of anti-intellectualism. Article selection was based on the subject matter that

provided further insight into Hofstadter’s analysis an anti-intellectualism and nursing

anti-intellectualism. Hofstadter’s book, about American anti-intellectualism, was the

37
primary source for this literature review. The gray literature includes published reports

and data sets from the ANA and the CDC.

Additional article selection was influenced by the methods used, specifically,

articles that focused on empirical research. Very little empirical research was found on

anti-intellectualism. Less than 10 empirical articles were found. The literature review

produced only five articles that directly addressed nursing anti-intellectualism and were

relevant to this research. Terms like nursing anti-elitism, nursing anti-rationalism, nursing

practicality, and the nurse theory-practice gap were used to obtain information about

nursing anti-intellectualism. The primary research databases utilized for this review were

CINAL, Sciencedirect, and EBSCOhost.

The review of literature provided a tool used to measure anti-intellectualism, and

an explanation of that tool’s implementation, history, reliability, and validity. The tool

was needed to determine the degree of anti-intellectualism existing within a group of

working nurses. The tool, the IAIS, is discussed in the literature and is used for this

research. The articles reviewed present an authoritative justification and explanation for

the research tool used in this study. The IAIS instrument was derived from important

aspects of Hofstadter’s (1963) anti-intellectualism analysis theory and examines the

central principles of Hofstadter’s analysis.

Additionally, the theoretical framework, Hofstadter’s (1963) analysis, provided

guidance in determining the intrinsic factors and the relationships that correlate with anti-

intellectualism for working nurses. The theoretical framework determined the scope for

the literature selection and those articles selected were compared to the central tenets of

the theoretical framework. The gap identified in the literature review pertains to the

38
actual degree of anti-intellectualism among the nursing workforce, and the intrinsic

factors that correlated with nursing anti-intellectualism. The literature reviewed does not

identify quantifiable factors for nursing anti-intellectualism. However, the review found

correlating components, based on the theoretical framework, that puts practicing nurses at

risk for having anti-intellectual tendencies. With the evolution of modern nursing

standards, practice, and education, the literature indicates elements of anti-

intellectualism. The risk for nursing anti-intellectualism is found in the forms of anti-

elitism, practicality, and anti-rationalism, all of which are likely propelled through the

vector of formal nursing education.

Analysis of Anti-Intellectualism

Scholars began to take note of anti-intellectualism, as a concept, when the term

was thrust into the spotlight with Hofstadter’s (1963) book, Anti-Intellectualism in

American Life. Anti-intellectualism can be found in the literature prior to Hofstadter’s

(1963) publication, despite its notoriety in the 1960s. However, the term anti-

intellectualism remained vague until Broudy’s (1954) analysis. According to Broudy

(1954), anti-intellectualism is not part of philosophical or theoretical ideology, nor is it

confined to a group’s ideals (however there are associations), but rather, a strategic

process for obtaining truths.

Daniel Rigney (1991) summarized and refined Hofstadter’s (1963) work with an

eye toward digestibility. Specifically, Rigney (1991) refined Hofstadter’s (1963) analysis

into three distinct subtypes of anti-intellectualism with clear definitions. Those subtypes

are (a) anti-rationalism via piety, (b) populist anti-elitism, and (c) unreflective

instrumentalism (Rigney, 1991).

39
 Pious anti-rationalism places value on rejecting rational reasoning (Rigney, 1991).

Anti-rationalist attitudes are derived from Protestantism, specifically evangelical or

fundamentalist ideas and religious constructs (Rigney, 1991). Rigney (1991) explains the

emotive relationships of anti-rationalism reasoning, associating rational, emotionless

reason with cold feelings, and intuitive, emotional reasoning with warm feelings. Rigney

(1991) further proposes that anti-intellectualism takes root due to the popular distaste for

an emotionless reason, and its perceived conflict with the sanctities of absolute belief.

Rigney (1991), then addresses populist anti-elitism as it applies value to intellect.

The value applied to intellect is of a negative sense and revolves around a mistrust of

wisdom that intellect provides (Rigney, 1991). Rigney (1991) expounds on how a

Jacksonian democracy fueled the wave of anti-elitism by giving a voice to the people

while invoking anti-aristocratic sentiments. Moreover, Rigney (1991) also addresses the

intellectual involvement of anti-elitist ideas.

Rigney (1991) coined the term unreflective instrumentalization, based on

Hofstadter’s work, as a means of providing a better working definition and a clear

concept of anti-intellectualism. Unreflective instrumentalism is the “devaluation of forms

of thought that do not promise relatively immediate practical payoffs” or pragmatic

practicality (Rigney, 1991, p. 44). Essentially, Rigney (1991) focuses more on economic

factors outside of a business, but as a maxim among the general population. Rigney

(1991) indicates that this form of anti-intellectualism results in the idea that if intellectual

development does not help gain capital, then it is not worth time or effort.

Further, Rigney’s (1991) work addresses an aspect of anti-intellectualism that

Hofstadter (1963) does not consider. Where Hofstadter (1963) looks to the American

40
educational systems as proliferating anti-intellectualism, Rigney (1991) points to mass

media. Rigney (1991) states that the link between anti-intellectualism and mass

communication both modernizes the concept and propagates it.

Other scholars have used Hofstadter and Rigney to evaluate anti-intellectualism

presence in various applications and environments. For example, Cross (1990) addresses

the relationships between the cult of practicality and the American tradition of being

apprehensive of the intellect. Cross’s (1990) cult of practicality correlated with Rigney’s

(1991) unreflective instrumentalism, but Cross looks to practicality as an unbreakable

cultural influence instead of a capitalistic gain. Cross’s work also heavily focuses on

Hofstadter’s (1963) concept of democratization of intellect but calls it the democratizing

of knowledge. Cross (1990), like Hofstadter (1963), addresses the democratizing of

knowledge from a historiographic perspective, but Cross places emphasis on higher

education and adds the component of historical racial inequality to this form of anti-

intellectualism. From Cross’s (1990) standpoint, the dichotomy of the American

perspective on intellectual pursuit places value on formal education, specifically higher

education, or at least that is a notation that is invoked.

De Simone (2001) addresses the influences of economics on the democratization

of education and the embodiment of corporate influences on education. De Simone

(2001) supports Hofstadter’s (1963) perspective on anti-intellectualism, specifically, the

democratization of intellect, and points out Hofstadter’s relevance 40 years later. De

Simone (2001) believes democratization of education needs further investigation while

building upon Hofstadter’s (1963) analysis from a modern perspective.

41
 Both scholars suggest that the value and reliability of the practical uses of

education, or even common sense, over the analytical abstraction is preferred to the anti-

intellectual (Cross, 1990; De Simone, 2001). Cross (1990), along with De Simone (2001),

believes this anti-intellectualism influences the educational systems through curriculum

changes, academic freedom, functional structures, revenue, and inclusivity. However, De

Simone (2001) suggests that the corporatization of America is part of the problem.

Empirical Literature

From Hofstadter’s 1963 work, little to no empirical studies were performed. This

drought ended in 2001 with Eigenberger and Sealander’s anti-intellectual study. Before

Eigenberger and Sealander’s (2001) research, no instrumentation existed to measure anti-

intellectualism. Several instruments have been created and used to explore the nature of

intellectualism and its character, but not anti-intellectualism (Eigenberger & Sealander,

2001). Additionally, those tools used to measure intellectualism tend to be impractical,

have limited access, and use multi-dimensional approaches (Eigenberger & Sealander,

2001).

Eigenberger and Sealander (2001) created a unidimensional research instrument,

based on Hofstadter’s analysis of anti-intellectualism. The instrument directly measures

anti-intellectualism in academic learners and is entitled the student anti-intellectualism

scale (SAIS). Eigenberger and Sealander’s (2001) tool quantifies the degree of anti-

intellectualism, and their research focused on university students’ attitudes and beliefs

towards academic pursuits, academic facilitators, and academia, in the general sense.

Eigenberger and Sealander (2001) a series of subsamples of university students from

42
different universities along with other measurement tools used to determine the SAIS’s

validity.

Eigenberger and Sealander’s (2001) research resulted in positive correlations

between high degrees of student anti-intellectualism with high degrees of right-wing

authoritarianism and dogmatism, commonly associated with “cognitive rigidity” (p. 393).

These results also correlated with Hofstadter’s (1963) subtypes of anti-intellectualism,

anti-rationalism, anti-elitism, and the spread of anti-intellectualism through the

democratization of knowledge. Per Hofstadter (1963), anti-intellectualism first got its

strong grip on our ways of thinking because it was fostered by an evangelical religion

that also purveyed many humane and democratic sentiments. Anti-intellectualism made

its way into our politics because it became associated with our passion for equality

(Hofstadter, 1963). Anti-intellectualism became formidable in our education partly

because our educational beliefs are evangelically egalitarian (Hofstadter, 1963).

Further, Eigenberger and Sealander (2001) found a relationship between anti-

intellectual scores and critical thinking, determined by the California critical thinking

skills test (Eigenberger & Sealander, 2001). These scholars concluded that students with

high levels of anti-intellectualism would reject and devalue intellectual pursuits, as well

as be less likely to participate in critical thinking activities (Eigenberger & Sealander,

2001). The data, again, supported Hofstadter’s (1963) construct of anti-intellectualism.

Though Hofstadter (1963) looks to the rise of the businessman and the flood of

capitalistic ideals as the driving force behind a culture of practicality, Eigenberger and

Sealander’s (2001) results still correlate with the ethos that efficiency and practicality

will provide more immediate payoff over intellectual pursuits. Additionally, Eigenberger

43
and Sealander’s (2001) study results suggest “the existence of attitude structure

resembling what has traditionally been thought of as anti-intellectualism” (p. 397).

Furthermore, the SAIS found a correlation, with possible causation of high degrees of

anti-intellectualism with low levels of openness to intellectual experiences (Eigenberger

& Sealander, 2001). However, Eigenberger and Sealander (2001) did not find a

significant correlation between anti-intellectualism and social approval and conformity.

Despite the positive results in Eigenberger and Sealander’s (2001) work, the

research has some disputed disparities. The wording of the SAIS tends to be more

pessimistic, hostile, and contrary to social normal opinions, which generated concerns

that participant responses were susceptible to “a socially desirable response”

(Eigenberger & Sealander, 2001, p. 395; Marques et al., 2010). However, the negative

language in the SAIS leads to a later modification of the scale, which will be discussed

further in this section (Eigenberger & Sealander, 2001; Marques et al., 2010).

Eigenberger and Sealander’s (2001) work has been criticized for their association

of anti-intellectualism with trait theory. Eigenberger and Sealander’s (2001) identified

anti-intellectualism as a subset of a personality trait that is associated with (a lack of)

openness for experiences, and because anti-intellectualism is seen as a personality

construct regarding openness or intellect, it falls within the realm of the five-factor model

of personality (Eisenberg & Sealander, 2001). Based on the psychological theory of the

five-factor model of personality, the authors of the SIAS go on to compare the

personality trait of anti-intellectualism with anxiety traits, stating that both traits can be

modified over time; the latter with therapy and the former with pedagogical intervention

to increase “critical thinking and motivate learning” (Eigenberger & Sealander, 2001, p.

44
398). The SIAS authors do not believe anti-intellectualism is a concept of learning but is

heavily rooted in an individual’s personality that has environmental influences

(Eigenberger & Sealander, 2001). Howley (2002) argues against Eigenberger and

Sealander’s (2001) ideas that anti-intellectualism is a trait. Howley (2002) states that anti-

intellectualism is derived from cultural influences and that Eigenberger and Sealander

(2001) do not have a rigorous proof for anti-intellectualism personality traits. Further,

Howley (2002) points to the rejection of an anti-intellectual trait among psychological

and sociological scholars, which includes Hofstadter (Howley, 2002). According to

Hofstadter (1963), the premise of anti-intellectualism is the social components that affect

knowledge, which makes up one’s cultural influences.

Despite the criticism of Eigenberger and Sealander’s (2001) work, their anti-

intellectualism tool, the SAIS, has been proven valid and reliable in the measurement of

anti-intellectual tendencies among students in higher education. Other researchers have

used the SAIS to explore anti-intellectualism among general academics, business,

education science, history, sociology, and psychology (Eigenberger & Sealander, 2001;

Laverghetta et al., 2007; Laverghetta, 2015; Laverghetta & Nash, 2010; Marques et al.,

2017). Many scholars continue to find correlational data linking student anti-

intellectualism to Hofstadter’s (1963) analysis.

Laverghetta used Eigenberger and Sealander’s (2001) SAIS tool in multiple

correlational studies (Laverghetta et al., 2007; Laverghetta, 2015; Laverghetta & Nash,

2010). Laverghetta et al., (2007) found quantitative data supporting Hofstader’s (1963)

analysis of political and religious social influences on anti-intellectualism. Laverghetta et

al. (2007) researched student political conservatism, which included religious and

45
economic factors, to anti-intellectualism scores. Laverghetta et al. (2007) found a strong

correlation between anti-intellectualism with political and economic conservatism.

Additionally, Laverghetta et al., (2007) collected general demographics which included

gender, college classification, political ideology, party affiliation, and race (Laverghetta

et al., 2007). They also found that freshman students had higher levels of anti-

intellectualism than graduate students and suggested a link between higher levels of

education to lower anti-intellectual tendencies (Laverghetta et al., 2007). Laverghetta et

al. (2007) work suggested that a higher degree of tertiary education can combat student

anti-intellectualism.

Further, Laverghetta and Nash (2010) use the SAIS tool to compare anti-

intellectualism levels with college majors. Laverghetta and Nash (2010) found students

with more “practically oriented majors” were found to have high anti-intellectual scores,

meaning more indicators for anti-intellectualism. Laverghetta and Nash’s (2010) study

will be the first empirical link between anti-intellectualism to nursing; this link to nursing

anti-intellectualism will be discussed further in the review.

Marques et al. (2017) created a new trajectory for quantitative anti-intellectual

research. Marques et al (2017) set out to develop a brief, self-reporting tool to measure

intellectualistic tendencies. Marques et al., (2017) devised their new scale with roots from

Eigenberger and Sealander’s (2001) scale, the SAIS.

Marques et al., (2017) shortened the SAIS, modified its language and focus, and

changed the intended population. The new scale is called the intellectualism-anti-

intellectual scale (IAIS). Instead of solely focusing on anti-intellectualism, the IAIS tool

allows for the measurement of both intellectual and anti-intellectual dispositions on a

46
linear continuum with anti-intellectualism and intellectualism on opposing ends (Marques

et al., 2017). The IAIS uses positive language and experiences when describing aspects of

intellectualism and anti-intellectualism, instead of negative language and perspectives

associated with anti-intellectualism, like the SAIS (Marques et al., 2017). Additionally,

the tool’s targeted population was expanded to measure anti-intellectualism among the

general population. The IAIS was tested with other relevant tools to measure anti-

intellectualism, including the SAIS, to determine the scale’s validity and reliability

(Marques et al., 2017). More details about the IAIS tool are discussed in Chapter III.

The IAIS scale was used to measure the Australian general population (Marques

et al., 2017). However, the sample used in Marques et al.’s (2017) work was primarily

university students, which they identify as a limitation in their work. Moreover, the study

did have several large samples. The samples included the following: one community

sample, five undergraduate, higher educational students’ samples, and one convenient

sample (Marques et al., 2017). The study did find significant demographic factors

associated with anti-intellectualism (Marques et al., 2017). As applied, the IAIS tool

indicates that older individuals had lower levels of anti-intellectualism when compared to

younger individuals (Marques et al., 2017). When comparing individuals with and

without formal higher education, individuals with tertiary education had higher degrees

of intellectualism, and those without had higher degrees of anti-intellectualism (Marques

et al., 2017). Marques et al. (2017) did not find any correlation factors between anti-

intellectualism, intellectualism, and gender.

47
 Nursing Literature

The term anti-intellectualism is not often found within nursing research; however,

the concept is addressed in the literature. Some literature discussed in this section

specifically addresses anti-intellectualism within the nursing profession (Clark &

Thompson, 2019; Miers, 2002; Racine & Vandenberg, 2021; Thompson & Watson,

2001; Walker, 1997), whereas other work discusses the concepts of anti-intellectualism

without direct use of the term (Chapman, 1997; Holmes et al., 2006; McCrae, 2012;

Murray et al, 2007; Risjord, 2010; Thompson & Darbyshire, 2012; Watkins, 2018; Webb,

2002). Despite anti-intellectualism being known as intrinsically American, the nursing

research that addresses anti-intellectualism is typically non-American, which can be

viewed as a reinforcement of American anti-intellectual culture.

The common trend of nursing anti-intellectual research focuses on the duality of

the profession with one vein supplying the practical application of nursing in the

workforce and the other focusing on scholastic pursuits. The nursing literature suggests

different causes and meanings for this duality, but all the scholars agree that it is a

negative part of the profession (Chapman, 1997; Racine & Vandenberg, 2021; Thompson

& Darbyshire, 2013; Thompson & Watson, 2001; Walker, 1997; Watkins, 2018). The

literature often suggests that this split translates from nursing’s historical background,

and its transgression into the nursing practice-theory gap (Chapman, 1997; Miers, 2002;

Racine & Vandenberg, 2021; Risjord, 2010; Watkins, 2018; Webb, 2002). Some nursing

scholars believe this division in nursing is due to a power struggle, rooted in snobbery,

between nursing scholars and researchers, and those who practice in the clinical setting

(Chapman, 1997; Racine & Vandenberg, 2021; Thompson & Watson, 2001; Thompson

48
& Watson, 2006; Webb, 2002). While other scholars look primarily to the practical

history of nursing, nursing education, and nursing research (Clark & Thompson, 2019;

Holmes et al., 2006; McCrae, 2012; Murray et al., 2007; Walker, 1997). Predominantly,

the review of nursing literature generated common themes that explicitly align with

Hofstadter’s (1963) anti-intellectualism, with one theme linked on a more abstract level.

These themes are used in the organization of this section of the literature review.

A point needs to be made that many of the nursing scholars addressed below,

point to anti-intellectualism as a problem with the individual nurse. These scholars

believed that this vein of nursing-based anti-intellectualism pertains to the traits that

individual nurses possess. Anti-intellectualism, as a trait, was as discussed, previously, as

a criticism of Eigenberger and Sealander’s (2001) work. Trait-based conceptions of anti-

intellectualism do not neatly dovetail with Hofstadter’s work, which broadly

conceptualized anti-intellectualism as the result of systemic, sociological factors

The nursing literature is categorized into five sections. Those sections are anti-

elitism, practicality, anti-rationalism, democratization of intellect, and quantitative data.

The first four subsections correlated with Hofstadter’s analysis of anti-intellectualism,

specifically the extrinsic factors that influence anti-intellectualism, and the last subsection

discusses quantitative data regarding nursing anti-intellectualism.

Anti-Elitism

Thompson and Watson’s (2001, 2006) editorials refer to an anti-intellectual ethos

that perfuses throughout the nursing profession. Thompson and Watson (2001, 2006)

specifically point to the manifestation of anti-intellectualism as anti-elitism. Racine and

Vandenberg (2021) also refer to anti-elitism, as a form of anti-intellectualism, through the

49
duality of nursing practice. The duality of nursing arises from the “opposing priority

between bedside and elite nurse” (Racine & Vandenberg, 2021, p. 2). Based on the

scholarly works discussed in this section, factors that influence anti-intellectualism, via

anti-elitism, is a nurse’s work environment.

Webb (2002) does not use the term anti-intellectualism, specifically, but describes

its elitist characteristics and origins within the nursing profession. The nursing

stereotypes of the bedside versus elite nurses are grounded in an us-versus-them

mentality (Webb, 2002). Practicing nurses see themselves as hard-working, but they lack

regard for the academic standards needed to produce qualified nurses (Webb, 2002).

Nursing scholars and researchers are described as out-of-touch, skillless, and removed

(Webb, 2002). As with most academics and scholars, nursing academics are also seen in

their ivory towers and are not taken seriously by the working nurse (Chapman, 1997;

Thompson & Watson, 2006; Webb, 2002). Thompson and Watson (2006) believe that the

‘ivory tower’ stereotype is further fueled because nursing academia and professors are

less focused on contributing to the nursing scholarship and advancement of the nursing

field, but on their own prodigious betterment (Thompson & Watson, 2006). Thompson

and Darbyshire (2013) address a similar issue, stating that the nursing elite has created

their own form of academic tyranny that does not allow for constructive criticism, and

disregards the traditional “ethos of debate” in scholastic culture (p. 1).

Further, Webb (2002) addresses a link between the battle of the bedside and the

elite nurse to the nursing practice-theory gap with the elite nurse representing nursing

theory and the bedside nurse representing nursing practice. The practice-theory gap, or

theory-research-practice gap, occurs when integrated knowledge about nursing practice

50
obtained in the academic setting is not consistent with ‘real-world’ clinical practice

(Watkins, 2018). Nursing’s standards of care are founded on the traditions of the clinical

setting. These dueling priorities manifest themselves in the nursing-practice gap in two

ways (Racine & Vandenberg, 2021; Risjord, 2010). One way is that nursing knowledge

development is good, but it is not well implemented into nursing practice; secondly,

“nursing’s theoretical knowledge is not useful to guide practice” at all (Racine &

Vandenberg, 2021, p. 2).

To bridge the gap between theory and practice and to resolve the notion that

nursing academics are out of practice, the scholarly vein of nursing has heightened focus

on research and teaching directly to practice (Chapman, 1997; Racine & Vandenberg,

2021). Racine and Vandenberg (2021) go on to say that “equating skills necessary for

practice with theoretical ignorance is problematic as it indirectly supports anti-

intellectualism” (p. 3). Racine and Vandenberg (2021) also link nursing anti-elitism to

Hofstadter’s (1963) practicality, or reflective instrumentation, though not directly

addressing Hofstadter. Racine and Vandenberg (2021) believe a cause-and-effect

relationship exists between the two forms of anti-intellectualism, and this relationship is

perpetuated by the nursing education system. How nursing education plays a role in

nursing anti-intellectualism, and its link to Hofstadter, will be discussed further in the

section.

Practicality

Anti-intellectualism, from a practical approach, is often discussed in the literature.

The fact remains that nursing is a practical profession and, historically, used practical

approaches to training, and these facts are antiquated knowledge (Clark & Thompson,

51
2019; Holmes et al., 2006; McCrae, 2011; Racine & Vandenberg, 2021; Thompson &

Watson, 2006; Walker, 1997; Watkins, 2018). The literature discussed in this subsection

emphasizes alternative rationales for nursing practical anti-intellectualism, or Rigney’s

(1991) term, reflective instrumentation.

Walker (1997) describes nursing anti-intellectualism as being anti-theoretical,

with a view of theory as synthetic semantics. Like other scholars, Walker (1997)

describes nursing anti-intellectualism as the catalyst force behind the theory-practice gap

and believes that the theory-practice gap further perpetuates nursing anti-intellectualism.

However, Walker (1997) is of the opinion that the practical history and conditioning of

the nurse have led to the practice-theory gap, and therefore, anti-intellectualism. In

accordance with Walker (1997), nursing anti-intellectualism is in the form of the

pragmatic and practical approach to performing nursing duties. Walker (1997) states that

pragmatism and practicality are influenced by nursing’s educational and training history

of apprenticeship, the ‘politics of gender’, and the social contrast that women are task

doers versus abstract thinkers (p. 5). Walker (1997) argues two points for anti-

intellectualism, both of which fall under Hofstadter’s (1963) description of anti-

intellectualism practical culture; like Hofstadter (1963), Walker (1997) looks to social

systems to explain anti-intellectualism.

The first point Walker (1997) makes specifically addresses the sociological

influence of gender on knowledge development. Walker (1997) states that women

dominate the nursing profession, and, as predominantly women, nurses value tasks

because women are good at tasks. In turn, nurses have created their own gate against

intellectual pursuit because they believe it is not good or beneficial, since it lacks hands-

52
on work (Walker, 1997). These ideas are further perpetuated, according to Walker

(1997), because thinking is considered patriarchal, and is often validated by the number

of men who dominate academia and other highly influential social systems. Additionally,

Walker (1997) explains that nurses will remain docile because they are women, and

women are dominated by the social pressures of being nice. In the nurse’s eyes, niceness

is considered the self-sacrificing part of caring, and caring is part of the nurse’s identity

(Walker, 1997). “A caring nurse, who is always nice to people is not likely to be an agent

of conflict and change” therefore, they become incarcerated by their own ideals (Walker,

1997, p. 8). Additionally, they value the ideals of a team, due to the caring and committed

nature of the female nurse (Walker, 1997). A team of submissive doers that values

practical skills will remain in the cult of knowledge that accepts domination by patients

and doctors (Walker, 1997). Ergo, these ideas create a self-perpetuating power of anti-

intellectualism.

Another point Walker (1997) makes about practical anti-intellectualism is

nursing’s historical apprenticeship approach to education. The idea of the apprenticeship

has influenced nursing’s task-oriented ways of learning how to ‘nurse’ on the job

(Walker, 1997). Learning on the job has conditioned nurses to rely on common-sense

decision-making, or rational, experienced truths (Walker, 1997). Traditionally, nurses

were not provided with the skills, let alone the language to express experiences and

practices in the theoretical realm (Walker, 1997). In the past, nurses looked to physicians

for their rationales and theoretical explanations (Walker, 1997). The utilization of the

physician curbed the need for the nurses to inquire further and kept nurses to their task-

oriented skillset (Walker, 1997). Clark and Thompson (2019) also address nursing anti-

53
intellectualism as it derives from not knowing. Clark and Thompson’s (2019) call to

action refers to nursing anti-intellectualism as toxic and explains that nursing anti-

intellectualism refers to research and its irrelevance because they reject what they do not

understand. Nurses are educated on science but do not feel confident in their

understanding of scientific inquiry (Clark & Thompson, 2019). Therefore, nurses, again,

stay in their comfort zones of task-based practice.

McCrae (2011) also discussed nurses’ propensity to value practical application

over theoretical development. McCrae (2011) does not use the term anti-intellectualism

in literature but describes the general quintessence of the practical flavor of anti-

intellectualism. McCrae (2011) describes some key points as to why the nursing

profession sides more with practicality than theory. Like other scholars, McCrae (2011)

looks to the nursing practical background but also suggests that nursing theoretical

development is stunted because the “meaning of nursing remains elusive” (p. 224).

Nursing’s theoretical development tends to be conceptual models, which are not highly

theoretical (McCrae, 2011). The abundance of theoretical models in the nursing scholarly

repertoire has led to an extreme level of abstraction, complexity, or simply filled with

metaphysical semantics that the average nurse cannot make sense of, let alone apply to

practice (McCrae, 2011). Thompson & Watson (2001) also provide evidentiary support

that aligns more with the practical pragmatism of anti-intellectualism. These scholars

state that nursing research, in the name of scholarship, is not a priority due to funding

issues, and the push for skills and competency-based research (Thompson & Watson,

2001). Regardless of the number of concept models nursing has contributed to the field,

54
nursing knowledge development still highly emphasizes hard scientific data, which is

addressed in more detail later in this section (Holmes et al., 2006; McCrae, 2011).

Anti-Rationalism

The closest tie nursing has to the religious influences of anti-intellectualism is the

loose link of morality, specifically, the moral underpinning applied to the nursing theories

of care and nursing ethics. Nursing history is rich with religious influences and

affiliations, and, according to Fowler (2009), the Christian perspective currently

intersects with nursing practice and education. However, the anti-intellectualism derived

from evangelicalism, as discussed in Hofstadter’s (1963) analysis, is not in nursing

literature. Yet, one abstract link to anti-rationalism is evidenced-based nursing.

Evidence-based nursing is the use of scientific research to determine practice

(Holmes et al., 2006). According to Walker (1997), nurses did not support evidence-

based nursing practice. Walker (1997) suggests that nurses do not like the sterility of

scientific inquiry believing it is “cool [and] detached,” devoid of passion and moral sense

for providing nursing care (p. 8). The notions of cold, neutral analytical reasoning,

associated with intellectual inquiry, correlate with Hofstadter’s (1963) anti-intellectual

analysis regarding religion. Where the evangelical following regard the academic

perspective on worship as flat and unfeeling, nursing sees the scientific inquiry through

the same lens (Walker, 1997). These ideas could speak to the timeframe in which

Walker’s (1997) work was published, for it contradicts other scholars’ opinions regarding

evidence-based nursing (discussed below).

Inversely, Holmes et al., (2006) state that the nursing professions are devoted to

evidence-based research, which is considered the best and only approach to creating new

55
nursing knowledge (Holmes et al., 2006). Holmes et al., (2006) critique modern nursing’s

dogmatic research mentality, stating that nursing research lacks diversity. Essentially,

nursing uses and accepts, without criticism, one type of research method and subjectivity,

the scientific inquiry of nursing clinical practice (Holmes et al., 2006). Nursing’s golden

standard for research and knowledge development is dangerous and does not vary out of

fear of illegitimacy and criticism (Holmes et al., 2006). Holmes et al. (2006) ideas of

dogma in nursing do not express themselves in the traditional Hofstadter manner.

However, nursing’s approach to knowledge development correlates to the operative of

the evangelical anti-rational system and the support for ‘absolutism’ based on fear. The

evangelists reject the non-theological and the nursing profession rejects the non-

empirical. These notions of fear also apply to nursing’s propensity to embrace the

practical, which is empiricism in design. However, one rejects the rational, when one

rejects the non-empirical; some things cannot be proven by evidence but by reason.

Concepts for nursing care and compassion are philosophical, and their understanding

relies on reason, not empirical science (McCrae, 2012).

Democratization of Intellect

The other factor that influences anti-intellectualism is the democratization of

intellect. The democratization of intellect is found in formal education and is the vector

that spreads anti-intellectualism. Nursing anti-intellectualism is also influenced by the

democratization of intellect through formalized nursing education, and the literature

supports this notion. However, before addressing the literature, the reader must

understand the constructors of formal nursing education. The section will begin with a

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general explanation of nursing degrees, followed by the components of anti-

intellectualism within nursing education.

Nursing degrees and licensure. Nursing is a practical profession, with a specific

skill set, often taught within an academic or vocational sphere. Nursing education and

licensure levels can vary. However, formal nursing education aims to produce entry-level

professional nurse generalists who must pass a standardized licensure examination to

practice. Specialty training is often completed on the job, but all nursing programs expose

students to different types of practice experiences.

The three distinct types of licensed nurses: are the practical nurse, the registered

nurse, and the advanced practice nurse. The practical nurse is different from the nurse

practitioner and is often referred to as a PN (practical nurse). The registered nurse is also

called an RN. Advanced practice registered nurses (APRNs) include nurse practitioners,

certified registered nurse anesthetists, clinical nurse specialists, and certified nurse-

midwives. APRNs first become an RN, then obtain a graduate nursing degree. All

nursing types must pass a licensure exam to become practicing nurses entering the

workforce under their educational title. PNs received their education through vocational

or community colleges. The PN completes a training program, which is roughly between

one to two years, to become eligible to take the National Council Licensure Examination

(NCLEX-PN). To become an RN, there are three points of entry for becoming eligible for

the national licensure exam (NCLEX-RN): an approved diploma program, an associate

degree in nursing (ADN), and a Bachelor of Science in Nursing (BSN). ADN and BSN

programs are found at the university or college level, whereas diploma programs are

often affiliated with hospitals. The trend and push in the profession are to have

57
baccalaureate degrees, and according to the NCSBN (2021a), over 50% of nurses have

BSNs. APRNs complete a graduate-level degree, after obtaining an RN licensure, to

become eligible to complete a state licensure exam for nursing practice, if required by the

state’s nursing board. APRN degrees are currently transitioning from a master’s level to

doctoral level education.

In addition to the degrees that make candidates entry-level professionals, nursing

has varying master's and doctoral level degrees, including those for APRNs. Nurse

practitioner degrees are practice and clinical-based, and others are academic and

research-based (e.g., the Ph.D.). Essentially, the nursing educational system can be

condensed into two pathways—the practical and the scholarly.

The two educational pathways tend to leave the theoretical pursuit to the nursing

scholars, while the rest of the field remains focused on practical skill sets. Most of the

highest degree levels in nursing are doctorate-prepared nurse practitioners (NCSBN,

2020, 2021a). In nursing, financial incentives are available to pursue academic education

over practical education. However, at graduate and postgraduate levels, those who

participate in the practical pursuits, over theoretical, are rewarded financially, leaving

scholars in the vast minority.

Nursing Education. In theory, formal education intends to facilitate intellectual

development, and therefore, eliminate anti-intellectualism. Yet, most anti-intellectuals

have some education, and a “degree of competency”, and “the leading anti-intellectuals

are...deeply engaged with ideas, often obsessively engaged with this or that outworn or

rejected idea” (Hofstadter, 1963, pp. 21-22). The development and influencing trends of

nursing education play into Hofstadter’s (1963) identified transmitter for anti-

58
intellectualism—the democratization of intellect. Each expression of anti-intellectualism

influences the spread of nursing anti-intellectualism because formalized nursing is

included in academia. Based on these notions, the more people who received formalized

nursing education, the more diffuse nursing anti-intellectualism can become. However,

the nursing profession has gained traction in improving its “occupational status through

better education” and credentialing, which is where the influence of elitism, practicality,

and anti-rationality begins (McPherson, 2012; Racine & Vandenberg, 2021).

The most current and informative analysis of nursing anti-intellectualism is A

philosophical analysis of anti-intellectualism in nursing: Newman's view of a university

education by Louise Racine and Helen Vandenberg (2021). As Racine and Vandenberg’s

(2021) philosophical analysis focuses on nursing academics’ contribution to nursing anti-

intellectualism, the work also addresses both anti-elitism and the practical components of

anti-intellectualism in nursing education. Racine and Vandenberg (2021) suggest that the

rejection of nursing’s history, for academic inclusion, is a part of the link to nursing

elitism, and nursing anti-intellectualism. Nursing, as a profession, is preoccupied with the

need for professional legitimacy, progressive, scholarly recognition, and desire for

academic inclusivity, and these preoccupied impulses come from the need to combat the

traditionally feminized “skills and past practice[s] [that] represent an anti-intellectual

discourse in nursing” (Nelson & Gordon, 2004; Racine & Vandenberg, 2021, p. 2).

Nurses no longer want to be synonymous with the idea that they are senseless doctor’s

helpers and believe that their education makes them more valuable (Miers, 2002; Nelson

& Gordon, 2004; Racine & Vandenberg, 2021).

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 Miers’s (2002) work provides more insight into nursing’s academic history and its

associations with anti-intellectualism. Miers (2002) addresses nursing anti-

intellectualism, as a cultural phenomenon derived from (a) the inclusion of vocational

training and former apprenticeships into academia and (b) the expansion of educational

opportunities for women. According to Miers (2002), nursing anti-intellectualism is seen

as a negative reaction, or defensive reaction, of placing critical and abstract thinking

above practical activity or skill. Miers (2002) also supports Hofstadter’s (1963) concepts

of anti-intellectualism, the practical approach outranking the theoretical for capital gain,

and anti-elitism. At the time, academically trained nurses were thought to have a false

sense of self regarding their education, and were perceived as privileged, and persnickety

(Miers, 2002). Additionally, the vocationally trained nurses believe formalized, academic

nursing education is unnecessary since it does not change the outcomes of workforce-

related rewards, which is an attitude that is still common today (Miers, 2002). Miers

(2002) addresses these two cultural influences as a means for creating an oppressed group

of academically trained nurses as the beginning of nursing educational duality. Since the

academically trained nurses were seen as a paradox, these nurses accepted their anti-

intellectually derived fate, which limited the expansion of their intellect (Miers, 2002).

Another aspect of nursing's unusual foothold in academia is its history of

vocational training using the apprenticeship model (Thompson & Watson, 2006). The

apprenticeship model was the traditional means of nursing education. However, the

apprenticeship model is beginning to be reintegrated into modern nursing education with

the use of preceptorships and calling into question nursing education’s legitimacy within

the field of academia (Holmes et al., 2008; Racine & Vandenberg, 2021). The

60
apprenticeship model is often seen as “non-scientific in university circles” and

perpetuates nursing’s image as a subpar academic discipline (Holmes et al., 2008; Racine

& Vandenberg, 2021). Losing academic respect creates a vicious cycle of anti-intellectual

resistance (Holmes et al., 2008; Racine & Vandenberg, 2021). Nursing scholars are

further divided by the drive to push for validity, which leads to two camps of thought—

the negative effects of academic elitism discussed above, or acceptance of a practical

fate, creating more polarized components of the nursing profession (Holmes et al., 2008;

Racine & Vandenberg, 2021; Rolfe, 2019; Webb, 2002).

The acceptance of nursing practical fate within academics is a common trend

found in formal nursing education (Racine & Vandenberg, 2021; Rolfe, 2019; Webb,

2002). The increasing uses of nursing education’s practical approaches to teaching

perpetuate anti-intellectualism (Racine & Vandenberg, 2021). Despite being modernized,

nursing education still supports “doing over thinking,” and these dominating ideas

“undervalue abstract thinking and undermine the acquisition of theoretical knowledge to

guide practice” (Racine & Vandenberg, 2021, pp. 5, 7). These ideals lead to anti-

intellectualism in nursing education. Additionally, the practical and anti-rational

approach to nursing education is supported by heavily competency-based curricula and

nursing’s faithful devotion to evidence-based nursing (Holmes et al., 2006; Racine &

Vandenberg, 2021). Further, the use of a competency-based curriculum is influenced by

the economic market. Nursing schools are pressured to meet the workforce’s demands for

nurses, in quantity and standardized quality through “mass education” (Racine &

Vandenberg, 2021, p. 8). In a focus on resolving economic problems, nursing education

has “expunged nursing theory for the context of nursing education” to make room for

61
teaching job-ready skills sets (Racine & Vandenberg, 2021, p. 8). Letting the labor

market dictate nursing education creates a culture of acceptance, which leads to partially

educated individuals (Racine & Vandenberg, 2021). To move away from their ivory

towers and the pressure of workforce-ready culture, nursing educators utilize hands-on

knowledge development to prepare students for the labor force (Racine & Vandenberg,

2021). Nursing instructors bring these practical ideas into the classrooms, where

traditionally, theoretical knowledge and reasoning are developed. Educators focus on

teaching memory over critical analysis (Racine & Vandenberg, 2021). Nursing

education’s focus on practical skills lowers achievement outcomes and neglects critical

thinking; these “lower standard of excellence and depreciation of intellectual work

characterizes anti-intellectualism in nursing” (Racine & Vandenberg, 2021, p. 8). In

addition, Racine and Vandenberg (2021), believe the corporatization of university

education, along with nursing education’s practical trends, leads to anti-intellectualism

and the jeopardizing of nursing academia.

Racine and Vandenberg (2021) state that a major influence on nursing education

and the influence of anti-intellectualism is the changing nature of higher education,

specifically universities’ alignment with corporate goals and mindsets. University

funding, as well as department allocation, is tied to achievement indicators like

enrollment rates, failure rates, pass rates, and student satisfaction, which does not

translate to academic excellence (Racine & Vandenberg, 2021; Rolfe, 2019). Higher

education is no stranger to budget cuts, leading to the limitation in resources as well as

facility members, which influences the ability to provide quality education (Racine &

Vandenberg, 2021; Rolfe, 2019). Additionally, universities are economically influenced

62
to meet the demands of the job market and the student’s willingness to pay for academic

education (Racine & Vandenberg, 2021; Rolfe, 2019). Universities have pushed for

virtual education and the use of web-based tools, which tend to be practical in nature, to

meet the student’s demands as well as maximize cohort sizes (Racine & Vandenberg,

2021; Rolfe, 2019).

According to Hall (2009), the use of technology can and has reduced academic

engagement among students and faculty and has led to the non-confronted spread of anti-

intellectualism. Hall (2009) believes that the use of a technological approach to nursing

education, and academic education in general, as a cure-all causes more side effects.

Faculty rely on technology to deliver the same quality of academic instruction to meet the

challenges of high workload, issues with student clinical placement, and multiple student

accommodations (Hall, 2009). However, excessive use of technology creates gaps in

communication, boundaries, expectations, engagement, and missed learning opportunities

(Hall, 2009).

Additionally, universities’ missions focus more on solving economic problems

over the production of intellectual society. The move to vocational missions and values

spills into the academic culture and influences the motives of each academic educational

system, including nursing. These university issues degrade academic culture and

intellectual influences, as well as nursing education’s ability to combat anti-

intellectualism (Racine & Vandenberg, 2021; Rolfe, 2019). Where academics once

served as a resource for nurturing nursing education’s intellectual side, now it is to

become a proponent of anti-intellectualism and has pushed nursing schools to become

focused on manufacturing nurses (Racine & Vandenberg, 2021).

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 The practical history of the nursing profession, plus its modernization within

academics and science, continues to contribute to nursing anti-intellectualism and its

peculiarity (Chapman, 1997). Evidence in the literature supports theoretical links to anti-

intellectualism in nursing education, and therefore among nursing students. In addition to

nursing education’s theoretical influences, the closest quantitative research link nursing

has to anti-intellectualism, is in nursing academics. Evidence in the literature reports

findings of anti-intellectualism among nursing students. The same student anti-

intellectualism scale (SAIS), created by Eigenberger and Sealander (2001), discussed in

previous sections found high levels of anti-intellectualism among nursing students.

Quantitative Data Regarding Nursing Anti-Intellectualism

The SAIS was applied in a study by Laverghette and Nash (2010). The study

looked for correlations between student anti-intellectualism scores and college majors

(Laverghetta & Nash, 2010). Laverghetta and Nash (2010) found that students with more

‘practically oriented majors’ were found to have high anti-intellectual scores meaning

more indicators for anti-intellectualism. Nursing majors were included in the practical

major group with high anti-intellectual scoring. The data from the Laverghetta and Nash

(2010) study indicates a likelihood that nurses are anti-intellectual. The study states its

results were “consistent with Rigney’s (1991) assentation that educational institutions

could be perpetuating the attitude of anti-intellectualism,” yet gaps remain in the

literature regarding the outcomes of nursing education on anti-intellectualism

(Laverghetta & Nash, 2010, p. 4).

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 Summary

Due to the identified gap in the literature, a question arises as to the extent to

which anti-intellectualism pervades the nursing profession. Accordingly, this research

determined if practicing nurses, who have completed their initial nursing education, have

associations with anti-intellectualism. The literature provides context for intrinsic factors

that possibly correlate with nursing anti-intellectualism.

One such factor is education. The literature states that individuals with higher

educational levels are, generally, less likely to have anti-intellectual tendencies

(Laverghetta, 2015; Laverghetta & Nash, 2010). However, nursing education is decidedly

pragmatic and instrumentalist in nature, suggesting risks for a higher rate of anti-

intellectualism compared to more abstract fields of study. The literature suggests that the

education system, itself, is a vector for such occupation centered field. A nurse’s highest

educational level and degree type are possible factors that correlate with higher levels of

anti-intellectualism, especially when comparing vocational training to academic training.

Beyond education, another possible intrinsic factor for anti-intellectualism is

gender and age. Some scholars address the culture of gender and its domination in the

profession as a factor for nursing anti-intellectualism. Walker’s (1997) opinion

specifically addresses how ideas of traditional feminized conditions nurses to value

hands-on, task-like work over the intellectual pursuit. Walker (1997) believes that

society’s influences on gender roles lead nurses to stand on the practical side of the

theory-practice gap. However, other quantitative literature did not identify gender as an

effect on intellect or anti-intellectualism (Marques et al., 2017). Yet, Marques et al.

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(2017) did identify age as a proponent of anti-intellectualism, stating that younger

individuals are more likely to experience anti-intellectualism.

As stated, the literature does not address specific intrinsic factors common among

nurses, outside of the ones addressed above. The lack of evidence in the literature review

provides an opportunity to find insight into the commonality, depth, and relationships of

anti-intellectualism within the nursing profession. The literature review has provided the

pathway to narrowing the research gap on anti-intellectualism in the nursing profession.

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 CHAPTER III - METHODOLOGY

Introduction

A gap in research has been identified regarding the existence of anti-

intellectualism within the nursing profession, and the relationship between anti-

intellectualism and the intrinsic factors that nurses share. The purpose of this research

aimed to determine and describe the effects of intrinsic factors and the degree of a

potential cause of anti-intellectualism, through quantitative means. The focus of the

research was (a) to describe the degree of nursing anti-intellectualism; (b) to determine

correlating factors, not causation, regarding nursing anti-intellectualism; and (c) to

determine strong predictors of anti-intellectualism among nurses.

To align with this study’s purpose, the design for this research is a descriptive

correlational design. Chapter III describes the research design in further detail and the

execution methods for this study. This chapter specifically discusses the study setting,

sample, instrumentation, data collection procedure, data analysis, and ethical

consideration.

Research Design

A descriptive design focuses on describing a specific population and the

occurrence of a phenomenon within that population (Creswell & Creswell, 2018; Gray et

al., 2017). This study contains components that align with the perimeters of a descriptive

design. One component of the study is to determine the existence and depth of anti-

intellectualism among practicing nurses. Additionally, this research design uses a survey

method.

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 A descriptive, survey design is used to answer descriptive-based research

questions, and research questions regarding variable relationships (Creswell & Creswell,

2018). Quantitative data was obtained from an online, self-reporting survey. The two-part

survey collected data pertaining to anti-intellectualism and demographic information. A

scale, entitled the intellectualism-anti-intellectual scale (IAIS), quantified the degrees of

anti-intellectualism, and the demographic data determined the common intrinsic factors

the nursing participants share. The research methodology helped tease out trends and

correlating factors among nurses who share high levels of anti-intellectualism, according

to the IAIS tool.

In addition to the descriptive element of this research, the study focused on

determining correlating relationships among variables (Gray et al., 2017). The study

describes factors associated with anti-intellectualism among practicing nurses and

identifies statistical significance among those factors and anti-intellectualism. Lastly, the

research also aimed to determine strong predictors of anti-intellectualism among nurses

by looking at correlations between variables, or intrinsic factors, specific to demographic

data. The focus on correlating variables and prediction falls under the parameters of

predictive correlation design, which intends to establish the strength of relationships

among variables with the end goal of prediction (Gray et al., 2017).

The variables studied included the practicing nurse's experiences of anti-

intellectualism and demographic variables. The nurse’s experience of anti-intellectualism

was measured with the IAIS. The IAIS resulted in interval data, however, this dependent

variable was converted into two categorical variables – anti-intellectualism and

intellectualism for the statistical analysis. The demographic data address both general

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demographics and demographics associated with nursing professionals. Demographic

variables are listed in Table 2.

Table 2

Demographic Variables

Variable Data type

Age Interval/Ordinal
Gender identity Nominal
Ethnicity Nominal
Marital status Nominal
Members of household Interval/Ordinal
Income Ordinal
Income affected by COVID-19 Nominal
Employment status Nominal
Employment contracts Interval/Ordinal
Leaving workforce Nominal
Nursing licensure Ordinal
Nursing Degree Ordinal
Nursing specialties Nominal
Current enrollment in school Nominal
Other degrees Nominal
Health insurance Nominal
Location/residency Nominal
Type of community Nominal
Community involvement Nominal
Degree of community involvement Ordinal
Political ideology Nominal
Political party affiliation Nominal
Religious affiliation Nominal
Christian religion affiliation Nominal
Religious level Ordinal

Setting and Sample

Sample

The desired population for the study is practicing nurses. The study targeted

current practicing nurses, who have practiced within the past two years. Subjects included

practical nurses (PN/LPN/LVN), registered nurses (RN), and advanced practice

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registered nurses (APRN). The data obtained from the nursing populations included

varying demographic data and quantitative data regarding anti-intellectualism.

The research obtained data from a large convenient sample size through online

recruitment. Online recruitment targeted social media sites (See Appendices D, G, F).

Multiple social media sites were used for the research setting. The parameter of

quantitative research establishes that a large sample size is needed to conclude the data

set (Gray et al., 2017; Waltz et al., 2017). Utilizing a convenience sample through social

media platforms allows easier and accelerated access to a large sample of the targeted

population, practicing nurses, with varying sociodemographics (Fricker, 2012; King et

al., 2014; Stokes et al., 2019).

Sample Size.

For this study, the sample size was estimated to be 403 subjects, calculated using

G*Power version 3.1 (Faul et al., 2009; G*power Manuel, 2021; Yenipinar et al., 2019).

The study used a logistic regression with a binary outcome for the x distribution in

G*power. The proportion of successful outcome for the target group was Pr (Y=1| X=1)

= H1 = 0.3 and the reference group was Pr (Y=1| X=1) = H0 = 0.5. The proportions

calculated an odds ratio of 0.43. The calculations used a targeted power of 0.9 (1 – β),

and a significance level of 0.05 (α = 0.05). R2 other X was determined by a rule of thumb

for naïve estimation with a strong association = 0.81 (Williamson, n. d.). The X

distribution is normal with the μ = 0 and σ = 1 (Williamson, n. d.; Yenipinar et al., 2019).

The strong association was chosen for its larger sample size calculation, and to

reduce the likelihood of misjudgments; therefore, possible type 2 errors (Faul et al., 2009;

Kuzma & Bohnenblust, 2004; Yenipinar et al., 2019).). According to the U.S. Bureau of

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Labor Statistics (2019a, 2019b, 2019c), approximately 2,986,500 RNs, 676,400

LPN/LVNs, and 211,280 APRN are employed in the United States. Therefore, a total

practicing nursing population of 3,874,180. Due to the number of American nurses, a

large sample size was needed to increase the likelihood of statistically significant results.

Considering the possibility of incomplete surveys, the estimated number of participants

needed is 524, based on an estimated 30% result of invalid surveys.

Eligibility criteria. To be eligible for participation in this study subjects self-

reported if they meet the following criteria:

● Participants are United States citizens.

● Participants understand the written English language.

● Participants have completed formalized nursing education in the United States.

● Participants have an active nursing license from the NCSBN.

● Participants have practiced under their nursing licensure within the past two

years or are currently employed within the nursing profession.

Setting

Multiple social media platforms were used to recruit subjects. The social science

components of anti-intellectualism and the tools that were used for data collection make

the utilization of an online social outlet appropriate. An online survey regarding societal

influences and demographic data would not come off as odd or unusual within the realm

of virtual socialization.

Additionally, the use of multiple social media platforms allows for data collection

from a large, more diverse population quickly and at a low cost (King et al., 2014). Social

media is now incorporated into daily life and content exposure has become more relevant

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(King et al., 2014). Social media platforms allow for inner and cross-site content sharing.

Content, or information, can be shared from person to person or across multiple media

sites. Some social media sites allow users to ‘post’ content on multiple social platforms

simultaneously. Content sharing creates a participant referral system, called snowball

sampling (Fricker, 2012; Stokes et al., 2019). Snowball sampling occurs when an initial

respondent recruits another potential study subject (Fricker, 2012; Stokes et al., 2019).

Snowball sampling was utilized with the aim that nurses and non-nurses would forward

the “recruitment message to others through ‘shares’ and ‘tags’” (See Appendices D, G, F)

(Stokes et al., 2019, p. 105). The utilization of snowball sampling methods allows easier

and direct access to prospective study participants who may be otherwise difficult to

reach (Fricker, 2012; Stokes et al., 2019; Gray et al., 2017).

According to the Pew research center, Facebook, Instagram, YouTube, Twitter,

Reddit, LinkedIn, TikTok, WhatsApp, Snapchat, and Pinterest are the top 10 fastest-

growing social media platforms in the United States (Auxier & Anderson, 2021).

Facebook, Instagram, LinkedIn, Twitter, and Reddit were used for this research. The

selection of these platforms is based on cost, accessibility, uses, and user demographics.

More specifically, each platform has a demographic-specific majority, and the

combination of the data obtained from each platform creates a more wide-ranging sample

collective. The rational specifics for the inclusion of each social media platform are

further discussed in this section. Furthermore, to obtain sample diversity, some social

media platforms were excluded. Exclusion points are (a) lower age ranges of its users,

which would not meet the inclusion criteria for the sample; (b) the risk of limiting sample

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diversity potential due to duplication of a specific demographic majority; and (c) feasibly

of recruitment due to the nature and intension of the platform.

Facebook is the second most popular social media platform; and due to its

intended uses for social networking, microblogging and popularity, the platform was

chosen for subject recruitment (Auxier & Anderson, 2021; Kühne & Zindel, 2020).

Facebook has a wide variety of demographics, including gender, ethnicity, age,

education, and population setting; additionally, the site is visited daily by most of its

users (Auxier & Anderson, 2021; Kühne & Zindel, 2020). The Facebook site allows for

public broadcasting of information on user pages and networking groups, specifically to

professional nursing groups, as well as recruitment through private messaging (King et

al., 2014; Kühne & Zindel, 2020; Stokes et al., 2019). Roughly 70% or greater of 18- to

64-year-olds use Facebook, and greater than 70% of 30 to 64 years old share content

through this platform (Auxier & Anderson, 2021). Like Facebook, Instagram is visited

daily by most of its users, at roughly 73% (Auxier & Anderson, 2021). Most Instagram

users range from the ages of 18 to 29 years old and are more commonly used by those

who live in urban settings (Auxier & Anderson, 2021). Instagram is also more popular

among minority groups—52o identify as Hispanic and 49% identify as Black (Auxier &

Anderson, 2021). The utilization of Instagram as a recruitment site has the potential to

obtain a younger, more ethnically diverse sample; See Appendix E for the recruitment

flyer (Kühne & Zindel, 2020).

LinkedIn was used for sampling due to the user type and functionality of the

platform. LinkedIn networking focuses on professional development and has users with

higher educational levels (Auxier & Anderson, 2021; Stokes et al., 2019). Approximately

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half of LinkedIn users have Bachelor’s or graduate-level degrees (Auxier & Anderson,

2021). Samples obtained from LinkedIn are more likely to meet the inclusion criteria for

this study. According to Stokes et al.’s (2019) online nursing recruitment data, LinkedIn

had a higher proportion of males than females. Stokes et al. (2019) also found that the

LinkedIn sample was “significantly older, higher educated, and more likely to work in

the community [nursing], [nursing] administration, [nursing] research, or [nursing]

education” (p. 106). Additionally, identifying and targeting practicing nurses as potential

subjects is much easier on an occupational-related platform (See Appendices E & F for

recruitment flyer). However, the downside to using LinkedIn is that users typically use

the site monthly (Auxier & Anderson, 2021).

Twitter was used for subject recruitment because of its accessibility, and

components of social networking and microblogging. Twitter is a less popular social

media platform; however, in part due to its cross-culture influences, it is a beneficial

source for health-related research, which includes its recruitment benefits (Arigo et al.,

2018; Auxier & Anderson, 2021; Sinnenberg et al., 2017). The publicity and visibility of

Twitter and its uses of hashtags—metadata tag, or label, that allows for term or content

search associated with characteristics of the label—allows users to provide additional

information about ‘post’ and created referral links (Berendt & Hanser, 2007; Berzofsky et

al., 2018; Yee, 2008). Hashtags can aid in finding and recruiting subjects associated with

specific terms while imparting additional information about this research project (Berendt

& Hanser, 2007; Yee, 2008). The hashtags #nurselife, #nurseproud, #nursing, #nurse,

#nurses #nursingresearch, #nursingresearchstudy and #nursesrock were used on Twitter,

Instagram, and Facebook.

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 Like Twitter, Reddit is not the most popular social media platform; however,

according to the Pew research center, the site’s growth in popularity is one of the most

statistically significant since 2019 compared to most of the other platforms (Auxier &

Anderson, 2021). As a social news site and forum, Reddit has double the number of

college-educated users when compared to those who have a higher school education or

less. Reddit, a male-dominated site, almost doubles the number of female users, which

would aid in obtaining a more gender-diverse sample group in a generally female-

dominated nursing profession (Auxier & Anderson, 2021; Barthel et al., 2016).

Moreover, the use of subreddits, or forum groups linked to demographics and popular

interests, helped target nursing professionals under nursing-related subreddits. One

concern for utilizing Reddit as a recruitment method is the influence of its culture. Reddit

culture is cynical and uninterested in those who intrude on conversation within the

subreddits, and users are insistent on blocking or ‘trolling’ intruders (Barthel et al., 2016;

Ohanian, 2021). Reddit is predominately influenced by liberal perspectives (Barthel et

al., 2016; Ohanian, 2021). However, the benefit of utilizing the Reddit platform to

achieve the targeted population outweighs the risk. Precautions were taken when

recruiting for the Reddit site; the survey used for the data collection on the site was

flagged in case of respondent bias. The survey link for each site was categorized

separately to also look at the trends among the social media sites.

Instrumentation and Materials

Quantitative data were collected with the intellectualism-anti-intellectual scale

(IAIS) to determine the depth of anti-intellectualism independent of intelligence

(Appendix A). In addition to the IAIS, demographic data were obtained from the nursing

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sample using a self-response questionnaire. Varying demographic data included gender,

age, ethnicity, family and personal income residential location, location of employment,

levels of education, licensure, years of nursing experience, professional nursing role and

experience, employment status, influences of COVID-19 on pay and work status, social

background, and social influences, including political, religious, and economic

perspectives and affiliations (Appendix B). The demographic questions for the

questionnaire were inspired by the national survey of college graduates (NSCG) created

by the United States Census Bureau, Dillman et al.’s (2014) online survey designs, and

the substruction devised, by this researcher, from this dissertation’s theoretical

framework.

Like the demographic questionnaire, the IAIS is a self-reporting survey through

which participants responded to a question set (Gray et al., 2017; Marques et al., 2017).

The IAIS tool measures intellectual and anti-intellectual proclivities on a continuum;

anti-intellectualism and intellectualism sit on contrasting ends of the continuum (Marques

et al., 2017). The survey questions focus on a person’s experience with intellectual

engagement, specifically intellectual activities. The questions target emotivism by

determining if intellectual participation is “either rewarding or aversive and

uninteresting” (Marques et al., 2017, p. 168).

The IAIS tool was modified from the validated and statistically reliable student

anti-intellectualism scale (SAIS). The measure is rigorous and well-calibrated. The

modifications were made to include the general population, specifically, those with

vocational interests, and refined to a 10-item scale (Marques et al., 2017). The IAIS is an

ordinal measurement scale. More specifically, the IAIS uses a Likert scale to determine

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the value associated with intellectual activity (Marques et al., 2017). The tool ranks

objects on “a 5-point Likert scale from 1=completely false to 5=completely true” with

some reverse scoring (Marques et al., 2017, p. 170). Total scores are averaged together

(Marques et al., 2017). Higher scores on the IAIS indicate positive associations with

intellectualism and lower scores indicate anti-intellectual tendencies (Marques et al.,

2017). The following are the IAIS scale items with (R) representing a reverse score item;

see Appendix A for a complete measure with Likert scoring:

• Working on difficult intellectual problems is enjoyable and stimulating for

me.

• I generally find physical or recreational activities more satisfying than

intellectual activities. (R)

• I tend to feel somewhat bored and impatient when dealing with remote,

theoretical problems. (R)

• Intellectual discovery is ok, but I prefer other forms of excitement. (R)

• I′m probably the sort of person who would find it thrilling to be engrossed in a

research project.

• I deliberately seek out sources of intellectual stimulation.

• I have more exciting things to do than sit around and think all day long. (R)

• I feel compelled to work on conceptual problems, even when I don't have to.

• One of my favorite activities is discovering alternative ways of explaining a

particular phenomenon.

• The process of examining a concept in great detail is generally unappealing to

me (R) (Marques et al., 2017).

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 Validity and Reliability

The intention of Marques et al.’s (2017) research was to create a scale for

measuring anti-intellectualism. Therefore, the researcher’s psychometric assessment

specifically focuses on determining the tool’s validity and reliability. Marques et al.

(2017) used multi-sample confirmatory factor analysis (MSCFA) to examine “the degree

of equivalence, or invariance, in the factor loading and correlations across samples” (p.

170). The researchers focused on demonstrating parallel findings from the sample

populations by testing the IAIS along with other relevant tools to determine the scale’s

validity and reliability (Marques et al., 2017). Those other tools included (a) the Schwartz

value survey, (b) the SAIS, (c) the cognitive flexibility scale, (d) the Marlowe-Crowne

social desirability scale, (e) the right-wing authoritarian scale, (f) Raven’s advanced

progressive matrices (abstract reasoning), (g) need for cognition scale, (h) dogmatism

scale, (i) epistemic preference indicator-revised (intellectual processing), (j) need for

cognitive closure scale, and (k) personal need for structure scale (Marques et al., 2017).

Validity

Each validity measure was compared by sample type, specific demographic

data—gender and age, and reliability. Six out of the 11 validity measurement tools had a

Cronbach’s alpha of greater than 0.83, and 5 validity measures had a Cronbach’s alpha

equal to 0.78. The specific degrees of validity used in Marques et al.’s (2017) research

are factorial validity, convergent validity, discriminant validity, concurrent validity, and

criterion validity. Many of these validity markers are subtypes often used within

psychology and sociology research, which is appropriate since the concept of anti-

intellectualism commonly falls within these disciplines (Marques et al., 2017).

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 Factorial validity is used to determine if the measure’s internal structures are

related to one another, and if the structure of the measure is interrelated with the

theoretical components or intention (Gray et al., 2017; Waltz et al., 2017). The

researchers determine factorial validity and measurement invariance by comparing the

results of their tools of the student and community samples, and the IAIS results with

another validated tool used to measure values (Marques et al., 2017). The results

indicated a positively related, and therefore, factorial validity (Marques et al., 2017).

Convergent validity, a form of construct validity, compares whether the results of

two different measures, which are intended to measure the same construct, are related

(Gray et al., 2017; Waltz et al., 2017). Marques et al. (2017) tested convergent validity by

measuring the IAIS and the SAIS, the mother tool, together. Similarly, concurrent

validity was also established with the IAIS (Marques et al., 2017). Concurrent validity

occurs when a new test, which measures a similar construct but is used differently from,

an established test is found to have correlating results (Kuzma & Bohnenblust, 2004).

Marques et al. (2017) found statistical significance when correlating the IAIS with other

valid tools regarding cognition.

Discriminant validity determines whether unrelated factors or constructs are,

indeed, unrelated, and different (Gray et al., 2017; Waltz et al., 2017). Discriminant

validity was determined by ensuring that the intellection components of the IAIS scale

were not related to authoritarian or societal standards (Marques et al., 2017). Criterion

validity was also established with the IAIS using demographic data (Marques et al.,

2017). Criterion validity compares results to a ‘golden standard’ or external variable

(Kuzma & Bohnenblust, 2004).

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Reliability

To determine the stability of the IAIS, Marques et al., (2017) demonstrated test-

retest reliability by administering the instrument in a follow-up study. Test-retest

reliability occurs when researchers compare the results from a tool administered twice to

a sample (Gray et al., 2017; Kuzma & Bohnenblust, 2004; Waltz et al., 2017). The

second administration of the study was found to be reliable, or stable, with a reliability

coefficient of .88 and a probability of <0.01 (Marques et al., 2017; Kuzma &

Bohnenblust, 2004).

Additionally, construct reliability was established with the one-factor model,

versus a Cronbach’s alpha, to determine the variance of the IAIS scale items (Marques et

al., 2017). Construct reliability determines the internal consistency of the items that

create a measurement scale, and a factor model analysis determines that item correlation

is based on one factor (Gray et al, 2017; Kuzma & Bohnenblust, 2004; Waltz et al.,

2017).

Based on the literature, the IAIS instrument has not been replicated in any

obtainable, published work at this time. Though this dissertation utilized a different

targeted population, the research outcomes have the potential to corroborate the IAIS’s

validity and reliability. The results of this study in comparison to Marques et al.’s (2017)

work will be discussed in the later chapters of this dissertation.

Procedure

Subjects were recruited through multiple social media platforms addressed in the

setting section of this chapter. King et al.’s (2014) social media recruitment strategies and

online data collection guidelines were used, especially the components about increasing

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response rates and recruiting tactics. Standardized recruitment messages and survey links

were published and circulated publicly on multiple social media platforms. Recruitment

messages were published to the general public with filter settings to target nurses, to

pages of nursing groups, this researcher’s personal social medial pages, and sent by

private messaging (Arigo et al., 2018; King et al, 2014; Stokes et al., 2019). The

recruitment messages contained information about the study and the criteria for

participation. As recommended by Stokes et al. (2019), the initial public advertisement

was followed by reminder publications at two weeks, four weeks, and six weeks.

Additionally, contact information was provided to encourage communication between

this researcher and participants; See Appendix H (King et al., 2014). Contact information

was included in a secured email address specifically used for research purposes, not tied

to any personal information or affiliations.

Recruitment messages contained both a hyperlink and a shareable link for an

online survey. The online survey contained a demographics questionnaire and the IAIS.

To mitigate participant bias, the online survey did not use the IAIS measure’s original

title and limited information was given regarding the aim of the research. Not using the

original survey title and limiting awareness of the study’s purpose is known as masking

(Gray et al., 2017; Waltz et al., 2017). Masking prevents a participant’s awareness of the

researcher’s intent and limits the unintended offensiveness the measure’s title may cause;

taking these steps limits participant bias or dissuade participation (Gray et al., 2017;

Waltz et al., 2017). If participants inquire about the nature of the study, participants were

told that the purpose of the research was to determine how nurses feel about academic

nursing education now that they are practicing nurses.

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 The design of the online survey utilized Dillman et al.’s (2014) approaches to

web-based questionnaire designs and online survey implementation. The online survey

began with inclusion criteria, which were also in the recruitment messages. Once

participants verified that they meet the inclusion criteria and consent to the survey

(Appendix G), they were allowed to complete the survey. The consent form ensured their

anonymity, and all collected data remained anonymous. The survey began with the IAIS

measure (Appendix A), followed by the demographic questions (Appendix B). The

survey was created using the electronic survey program, Qualtrics, and the raw data were

stored through the Qualtrics site. The IAIS contains only self-reporting rating-style

questions. The IAIS uses a five-point Likert scale, ranging from ‘completely false’ to

‘completely true’. The demographic portion of the online survey contained dichotomous

questions, multiple-choice questions, and a few open-ended questions that allowed

participants to fill in their answers. The online survey was set to limit multiple survey

completions.

Data Analysis

For the data analysis, precision is of the utmost importance to maintaining rigor

(Gray et al., 2017). The raw data was exported from Qualtrics to SPSS, version 28. When

needed, data cleaning occurred for missing items, outlying information, and survey

inaccuracies (Gray et al., 2017). Scores for the IAIS portion of the survey were calculated

for each participant. Discrete numerical data were used for the IAIS scores (Gray et al,

2017; Kuzma & Bohnenblust, 2004). The total IAIS scores were also converted into

binary categories for the regression portion of the analysis. Some demographics were

categorized into numerical systems within SPSS. Categorical data, current nursing

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position, educational level, licensure, and age, to name a few, and nominal data included

factors like gender, race, political preference, religious preference, and residence/setting;

See Table 2 for a complete variable list.

A descriptive, correlational, and regression analysis was used for this study’s data

analysis. Each research question determines a specific data analysis. Research question

one (RQ1) asked the degree of anti-intellectual existence among a group of working

nurses. The IAIS measure determined intellectual and anti-intellectual levels, and

descriptive statistics were used to determine the central tendencies of data produced from

the IAIS measure. The data analysis determined the frequencies, distributions, means,

standard deviations, and percentages to identify the rating of anti-intellectualism and the

demographic data obtained from a group of practicing, American nurses.

The second research question (RQ2) aimed to determine what intrinsic factors

nurses possessed with a high degree of anti-intellectualism. Essentially, the study looked

for relationships between intrinsic factors (independent variables), like the ordinal

demographic data, and the total anti-intellectualism (dependent variables) scores.

Correlation procedures were used for determining the existence of relationships between

intrinsic factors, and the intellectualism variable measured on the IAIS. A Spearman’s

Rho was utilized to examine these relationships (Gray et al., 2017; Kuzma &

Bohnenblust, 2004).

The Spearman’s ranking coefficient correlation, or Spearman’s Rho, is a

nonparametric analysis used for determining relationships between interval and ordinal

data (Gray et al., 2017). The IAIS is comprised of multiple Likert scales, which are

ordinal in nature; however, the total score of the total IAIS score was used for the

83
analysis. The total IAIS score is considered interval data and is appropriate to use for

Spearman’s Rho correlational testing. Further, components of the demographic data that

were collected have a natural order, like levels of licensure and education, which is also

appropriate for Spearman’s Rho analysis. The completed list of ordinal demographic data

can be found in Table 1.

The third research question (RQ3) determined which intrinsic factor indicated a

likelihood of anti-intellectualism among working nurses. RQ3 aimed to determine the

relationship between multiple independent variables, or intrinsic factors, and the total

IAIS scores. When investigating the relationships between independent variables, which

are categorical or binary, and one dependent variable, that is interval, a logistic regression

analysis can be used (Gray et al., 2017). A logistic regression can determine the most

powerful predictor variable that correlates with the dependent variable, the probability of

falling into a specific group; for this research, the group was anti-intellectualism (Gray et

al., 2017). Therefore, the use of logistic regression to classify the independent variables,

demographic data, as predictor variables for the dependent variables, and IAIS scores

were appropriate (Gray et al., 2017). The total IAIS was converted to a binary variable,

anti-intellectual/intellectual. The categorical demographic data were converted into

dummy variables for the analysis (Crowson, 2021; Osborn, 2015). For the data analysis,

odds, specifically log odd, were used as predictors instead of probability, to make linear

relationships (Crowson, 2021; Osborn, 2015). Odds describe the chance that an event will

occur (Crowson, 2021; Osborn, 2015). The data analysis looked for statistical

significance between the independent variables, and intrinsic factors, to determine the

likelihood of anti-intellectualism among working nurses.

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 Hypothesis

Based on the research questions, the three null hypotheses were:

• H1: anti-intellectualism does not exist among practicing nurses.

• H2: There is no significant relationship between IAIS scores among practicing

nurses and the demographic data.

• H3: There are no intrinsic factors that could determine the likelihood of low

IAIS scores among practicing nurses over what would be expected by chance.

Ethical Considerations

Prior to implementation, the research study was submitted to The University of

Southern Mississippi’s IRB for approval. IRB approval was granted (protocol # 21-355;

See Appendix C). The standard ethical considerations used for participant recruitment

and data collection applied in the offline setting were used in this online setting (Arigo et

al., 2018; Beninger, 2016; Gelinas et al., 2017). Informed consent, animosity, and undue

harm were the primary focus for maintaining participants’ rights.

Informed content was obtained at the beginning of the online survey on the

Qualtrics platform (see Appendix G) Participants gave electronic consent by selecting the

consent option on the survey. Participants were not allowed to advance to the survey

portion without consent. Participants were ensured of their privacy during the consent

process. The participants were also provided with the researcher’s and the USM IRB’s

contact information, at the beginning and the end of the online survey. Participants were

encouraged to make contact regarding questions or concerns (see Appendix H).

Participant privacy was maintained by the anonymity of the survey. Photographs,

sensitive content, names, or personal information, outside of the demographics listed in

85
Appendix B, were not collected. Furthermore, little information considered socially

delicate was collected (Fricker, 2012). The data collected from the online survey was

housed on a password-protected computer. No URL information was collected during the

data collection process.

To avoid undue harm, the name of the IAIS scale and the intentions of the

research were omitted from the online survey (Beninger, 2016). Permission to use the

IAIS measure has been given by its author, however, permission has not been granted to

change the name of the measure. Therefore, the measure’s title and the term anti-

intellectualism were omitted. Transparency is an important component of social media

recruiting; however, with this dissertation, the potential risk for bias, skewed data, and

cause of offense is too great (Gelinas et al., 2017). Once participants completed the

survey, they were informed of the true intentions of the research (see Appendix G)

Additionally, the utmost professionalism was maintained in all interactions with

participants (Beninger, 2016; Fricker, 2012; Gelinas et al., 2017). Recruiting and

contacting potential participants through social media, who do not have a social

connection to this researcher, has a factor of creepiness that must be avoided (Arigo et al.,

2018; Gelinas et al., 2017). Furthermore, all website policies for publishing content and

recruitment were followed for each social media platform (Arigo et al., 2018; Gelinas et

al., 2017).

Summary

The study used a descriptive, correlational design. The measurement used for this

research has validity and reliability. In addition, the measurement has generalizability.

The measurement was modified from a previously developed scale for broader

86
application to the general population and was shortened for practical purposes. The study

aimed to generalize the target population using participants from multiple social media

platforms. The use of social media platforms can cause limitations to the generalizability

of the finding in this research. However, the recruitment efforts and tactics taken during

data collection created validity of the data.

87
 CHAPTER IV – RESULTS

Introduction

Chapter IV presents the results of the data analysis in determining the

demographics and existence of anti-intellectualism among practicing American nurses

from an empirical perspective. The purpose of this descriptive, correlational study was to

determine the (a) degree of anti-intellectualism among practicing nurses; (b) the

correlation between these nurses’ demographic data and anti-intellectual levels; and (c) a

potential indication, based on demographic data, of the anti-intellectualism among

practicing, nurses.

The data analysis was based on the data collected over a six-week period using

the Qualtrics program. The Qualtrics survey collected data electronically. Initially, 768

American nurses participated in the study. However, only 639 surveys were utilized for

the analysis. The data was imported from Qualtrics and analyzed with SPSS, version 28,

software. The data was cleaned and coded to fix the analysis models.

A frequency distribution, bivariate correlation (Spearman’s Rho), and a logistic

regression analysis were utilized. The frequency distribution analysis is used to determine

the degree of anti-intellectualism among a group of practicing nurses. The Spearman’s

Rho looks for correlations between the demographic data and anti-intellectual levels.

Finally, the logistic regression looks for likelihoods, or predictor odds, based on the

demographic data, for lower IAIS scores, which indicate anti-intellectualism. The data

analysis begins with a descriptive analysis, followed by a correlational analysis.

88
 Descriptive Data

The descriptive statistics used frequency distributions for its analysis. The data

analysis includes the quantified survey results based on demographic data and key

findings from the anti-intellectualism (IAIS) scale. The analysis begins with demographic

information, followed by anti-intellectualism scores.

Demographic Data

The highest number of nursing participants' age ranges were 25 – 34 years old at

47% (n= 303), followed by 35 – 44 years old at 29% (n=185). The frequency of 18 – 24

years old was 7% (n= 43), 45 – 54 years old at 11% (n=72), 55 and older 5% (n=36).

Most of the participants were female, with 82% (n=525). The male response rate was

16% and those who identified as transgender or non-binary were at 1%. The participants

who described themselves as White had the highest response rate at 88%. Those who

identified as Asian were 4%. The percentage of participants who described themselves as

Black was 3%. The selection of races such as Native Hawaiian, Pacific Islander, Asian,

Alaskan Native, and American Indian was <1%. Participants that selected multi-

ethnicities were at 8%, and those who selected Hispanic, Latino, or Spanish descent were

at 13%. Regarding marital status, participants who were married or in a domestic

partnership were recorded as 65%. Participants who selected single were at 27%. Those

participants who selected divorced or separated were at 8%, and <1% of the participants

selected were widowed.

The data results indicated that participants resided in all regions of the United

States. The U.S. regions included Southern, Western, Midwestern, and Northeastern

states with 1 (1%) U.S. citizens currently residing in Finland, which is indicated as

89
outside of the U.S. in Table 2. The southern states included Alabama, Arkansas,

Delaware, the District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland,

Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and

West Virginia. The number of participants from Southern states was 262 (41%). Western

states included Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada,

New Mexico, Oregon, Utah, Washington, and Wyoming. The number of Western state

participants was 148 (23%). Midwestern states included Illinois, Indiana, Iowa, Kansas,

Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and

Wisconsin. The number of participants from Midwestern states wwas129 (20%).

Northeastern states included Connecticut, Maine, Massachusetts, New Hampshire, New

Jersey, New York, Pennsylvania, Rhode Island, and Vermont. The number of participants

who resided in the Northeastern state wewas2 (14%). The frequency of community types

was as follows: large city n = 205 (32%), suburb, near a large city, n = 187 (29%), small

city or town n = 177 (28%) and rural area 70 (11%). The frequency of those who were

actively involved in their community was 69% (n = 442), with 14 (2%) of the participants

very involved and 124 (19%) of the participants somewhat involved in their community.

Participants were asked to identify a political ideology that closely aligns with

their political beliefs. The results for political ideology were 62% (n = 369) liberal, 28%

(n = 176) moderate and 9% (n = 57) conservative. Political party affiliations were 59% (n

= 376) democratic, 15% (n = 95) independent, 10% (n = 65) republican, 3% (n = 17)

libertarian, and 13% (n = 81) had no party affiliation. A large percentage are registered to

vote, at 96%, and 89% voted in the last presidential election.

90
 In addition to political affiliations, the survey addressed religious affiliations. The

data indicates that 365 (57%) participants were not religious, 115 (18%) participants were

slightly religious, 104 (16%) participants were moderately religious, and 52 (8%)

participants were very religious. Those participants who indicated slightly, moderate, or

very religious, n = 269 (42%), identified with Christianity, at 36% (n = 227), as the most

common religious organization. Those who belong to Christian religious organizations,

identified theses most common denominational areas: Catholic at 10% (n = 62) and

Baptist at 5% (n = 31). Other commonly identified Christian religious organization were

non-denominational at 10% (n = 63) and other at 3% (n = 21). See Table 2 for more

information regarding additional religious affiliations.

The nursing participants were asked to indicate their current nursing licensure.

The nurse participants who currently have a practical or vocational license were at 6%.

Those who practice under a registered nurse licensure make up 89% of the nursing

participants, and advanced practice registered nurses (APRNs) are 8% of the participants.

Most of the nursing participants have a bachelor’s degree in Nursing, at 58%, which is

followed by associate degrees in nursing at 18%. A total of 12% of master’s degrees,

including practitioners and non-practitioners, and doctoral degrees at 4%, including

practitioners and non-practitioners. All graduate practitioner degrees including master's

prepared and doctoral prepared were indicated by 6% of the participants. The percentage

of non-nurse practitioner’s degrees was a0%. The results indicated that 111 (17%) were

currently obtaining additional nursing degrees. A total of 252 (39%) nursing participants

had additional, non-nursing degrees. The highest percentages of additional, non-nursing

degrees were science-based degrees at 19%, closely followed by liberal arts degrees at

91
15%, and 26% of those degrees were bachelor’s degrees. See Table 3 for more

information regarding additional educational information.

The demographic survey also addressed employment information. The results

indicate that 488 (76%) of the participants were employed full-time at a minimum of 36

hours per week. Over half of the participants indicated that they had health insurance

through their employer at 67% (n = 429). Participants were also asked if they have

multiple jobs and 127 (20%) participants indicated they had a second job. The most

common secondary employment position was PRN or per diem at 14% (n =88). The three

most common areas of practice were critical care at 19%, emergency care at 13%,

medical-surgical, and acute care at 13%. Participants who held specialty or practice area

certifications were 67% (n = 234). A small percentage of participants have recently left

the workforce, 7% (n=46), and 11% (n = 67) have intentions of leaving the nursing

profession. Some of the participants have considered leaving the nursing profession at a

total of 28% (n = 180). See Table 3 for the complete demographic information on the

collected data.

Table 3

Descriptive Statistics of Demographic Variables

Variables Frequency %
Age
18 – 24 43 (7%)
25 – 34 303 (47%)
35 – 44 185 (29%)
45 – 54 72 (11%)
> or = 55 36 (5%)
Gender
Female 525 (82%)
Male 101 (16%)
Transgender or Non-binary 9 (1.4%)

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Table 3 (continued).

Ethnicity
White 563 (88%)
Asian 23 (4%)
Black 17 (3%)
Hispanic, Latino, or Spanish 80 (13%)
Multiple Ethnicities 30 (8%)
Native Hawaiian/Pacific Islander, Native 4 (<1%)
American/Native Alaskan
Marital Status
Married or domestic partnership 414 (65%)
Single (never married) 172 (27%)
Divorced or Separated 49 (8%)
Widowed 4 (<1%)
Location
Southern States 262 (41%)
Western States 148 (23%)
Midwestern States 129 (20%)
Northeastern States 92 (14%)
Outside of the U.S. 1 (1%)
Licensure
Registered nurses (RN) 567 (89%)
Advanced practicing nurses (APRN) 49 (8%)
Licensed practical or vocational nurses
(LPN/LVN) 41 (6%)

Highest nursing degree or

level completed Bachelor’s degree in nursing 371 (58%)
Associate degree in nursing 117 (18%)
Master’s degree in nursing – Nurse 54 (9%)
practitioner or nurse anesthesia
Practical nursing certification 35 (6%)
Master’s degree in nursing 25 (4%)
Doctor of nursing practice or nurse 13 (2%)
anesthesia
Doctor of philosophy in nursing 11 (2%)
Diploma in nursing science 4 (<1%)
Doctorate of nursing science 3 (<1%)
Current enrollment in a
nursing program Total 111 (17%)
RN to BSN 29 (5%)
MSN 17 (3%)
MSN – NP 14 (2%)
RN to MSN 14 (2%)
RN to DNP 9 (1%)
LPN to RN (Associates or bachelor’s 8 (1%)
degrees)
DNP/DNAP 7 (1%)
PhD 7 (1%)
Post-master’s certification 1 (<1%)
Not enrolled 528 (83%)
Plan to enroll in nursing program
within 12 months 45 (7%)
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Table 3 (continued).

Other non-nursing degrees

Total (Yes selection) 252 (39%)
Total Liberal Arts degrees 15%
Total Science degrees 19%
Total Business degrees 1%
Total Associate degrees 5%
Associate of Art 4 (<1%)
Associate of Science 9 (1%)
Associate of Applied Arts 1 (<1%)
Associate of Applied Science 15 (2%)
Associate of General Studies 1 (<1%)
Total bachelor’s degrees 26%
Bachelor of Arts 82 (13%)
Bachelor of Science 76 (12%)
Bachelor of General Studies 3 (1%)
Bachelor of Business 5 (1%)
Total master’s degrees 5%
Master of Art 7 (1%)
Master of Science 18 (3%)
Master of Applied Science 4 (1%)
Master of Business Administration 4 (1%)
Doctor of Philosophy 2 (<1%)
Nursing specialty certification
234 (67%)
Employment status
Full-time (36 or more hours per week) 488 (76%)
Part-time (24 to 36 hours)
PRN or per diem 93 (15%)
Full-time student 38 (6%)
Contract 36 (6%)
Unemployed not looking for work, 18 (3%)
homemaker, or unable to work 12 (2%)
Unemployed currently looking for work
Retired 5 (<1%)

5 (<1%)
Travel Nurse
Total nursing of travel nurses 54 (9%)
1-2 contracts per year 18 (3%)
3-4 contracts per year 33 (5%)
5-6 contracts per year 1 (<1%)
> 6 contracts per year 2 (< 1 %)
Nurses with multiple jobs
Total 127 (20%)
Second job – PRN or per diem 88 (14%)
Second job – part-time 18 (3%)
Second job – full time 3 (<1%)
Two additional jobs – PRN 5 (1%)
Second job – non-nursing 1 (<2%)
Health insurance through a job
429 (67%)

94
Table 3 (continued).

Nursing specialty/practice
area Critical care 122 (19%)
Emergency care 83 (13%)
Medical-Surgical care 80 (13%)
Pediatrics 49 (8%)
Acute care specialties 46 (7%)
Telemetry/cardiology 40 (6%)
Mental and behavioral health 39 (6%)
Gerontology, long-term and palliative care 38 (6%)
Women’s Health 37 (6%)
Perioperative care 35 (6%)
Interventional Specialties 19 (3%)
Primary care 17 (3%)
Post-acute care 12 (2%)
Academia and research 3 (<1%)
Informatics 2 (<1%)
Corrections and Forensics 2 (<1%)
Case Management 2 (<1%)
Aesthetics 1 (<1%)
Recent left workforce
46 (7%)
Intentions of leaving
workforce No 390 (61%)
Maybe 180 (28%)
Yes 67 (11%)
Pay rate/income affected by
COVID-19 Yes 341 (53%)
No 295 (46%)
Household income
< $70,000 24 (6%)
$70,000 - $79,999 16 (3%)
$80,000 - $89,999 27 (4%)
$90,000 - $99,999 29 (6%)
$100,000 - $149,999 151 (24%)
$150,000 - 199,999 96 (15%)
$200,000 - $299,999 43 (7%)
> $300,000 22 (3%)
Members in household
1 84 (13%)
2 253 (40%)
3 110 (17%)
4 114 (18%)
5 50 (8%)
6 18 (3%)
7 or more 6 (1%)

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Table 3 (continued).

Primary source of
healthcare trends that affect Professional associations 183 (29%)
nursing practice Employer 138 (22%)
Experts in the field 80 (13%)
Social media 78 (12%)
Professional peers 63 (10%)
Mainstream media (TV, radio, 38 (6%)
newspapers)
Governmental agencies 26 (4%)
Other 19 (3%)
Social groups including family and friends 6 (<1%)
Community/location type
Suburb, near a large city 205 (32%)
Large city 187 (29%)
Small city or town 177 (28%)
Rural area 70 (11%)
Community involvement
Involved in community 195 (31%)
Somewhat involved 124 (19%)
Moderately involved 57 (9%)
Very involved 14 (2%)
Political ideology
Liberal 396 (62%)
Moderate 176 (28%)
Conservative 57 (9%)
Political Party affiliation
Democrat 376 (59%)
Independent 95 (15%)
None 81 (13%)
Republican 65 (10%)
Libertarian 17 (3%)
Green party 2 (<1%)
Voting
Registered to vote 615 (96%)
Voted in last presidential election 571 (89%)
Level of religiousness (considers
self religious) Not religious 365 (57%)
Slightly religious 115 (18%)
Moderately religious 104 (16%)
Very religious 52 (8%)
Do not know 3 (<1%)
Religious organization
Christianity 227 (36%)
Other 20 (3%)
Judaism 10 (2%)
Not part of a religious organization 8 (1%)
Islam 2 (<1%)
Asian folk religion 2 (<1%)

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Table 3 (continued).

Christianity denomination
Non-denominational 63 (10%)
Catholic 62 (10%)
Baptist 31 (5%)
Other 21 (3%)
Methodist 16 (3%)
Episcopalian, Presbyterian, or Anglican 13 (2%)
Evangelical
Lutheran 7 (1%)
Pentecostal 5 (<1%)
5 (<1%)

IAIS data

Each of the 10 statements on the IAIS was scored with a Likert scale that had a

range of 1 through 5. Lower scores indicated that the IAIS statement was false, and high

scores indicated that the IAIS statement was true, except for four statements with reverse

scoring. The total IAIS score was calculated and used for the analysis in SPSS.

Lower scores on the IAIS indicate higher degrees of anti-intellectualism. Scores

less than 30 indicate anti-intellectualism. Higher scores on the IAIS indicate higher

degrees of intellectualism, and therefore low degrees of anti-intellectualism. IAIS scores

greater than 30 indicated low degrees of anti-intellectualism. According to the data

analysis, 35% (n = 222) of nursing participants scored low on the IAIS scale, indicating

higher degrees of anti-intellectualism. The highest levels of anti-intellectualism (the

lowest IAIS scores) were 1%. Most of the nursing participants, at 65% (n = 417), had

higher scores on the IAIS scale with the least degrees of anti-intellectualism at 3%. A

small portion of participants had more neutral tendencies at 4% (n = 25).

The distribution of the total IAIS scores was arranged into a histogram for a visual

interpretation of the data, see Figure 1 below. The frequency of the IAIS scores appears

97
to be a slightly left skew. The frequency of higher IAIS scores fell into the upper

boundaries of the data set. Additionally, the central tendencies of the total IAIS score and

the frequencies of each of the ten IAIS statements are listed in Table 3 Descriptive

Statistics of Intellectual-Anti-intellectual Scores (IAIS).

The frequency of the lower IAIS score indicates that anti-intellectualism does

exist among a group of practicing nurses. The findings indicate that 35% of this study’s

participants were found to score within the anti-intellectualism range. Therefore, the null

hypothesis stating that anti-intellectualism does not exist among practicing nurses is

rejected.

The demographic data was heavy on categorical variables. Therefore, some of the

demographic data were cross-tabulated with total IAIS scores to provide a better picture

of patterns and possible correlations in the data set. The IAIS scores were categorized

into anti-intellectualism and intellectualism. The demographic variables presented in

Table 5 were specifically chosen because they represent the only independent variables

determined to have statistically significant correlations with the total IAIS score or

variable use in the discussion in Chapter V. The variables with significant correlations are

discussed further in this chapter. See Table 5 for more information on the cross-

tabulation.

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Figure 1. Histogram of Total IAIS Scores.
Histogram created in SPSS of IAIS total scores.

Table 4

Descriptive Statistics of Intellectual Anti-intellectual Scores (IAIS)

Variables Central Tendency

Total IAIS scores
Mean 33.4
Median 34
Mode 37
Variable Frequency %
Frequency scores
Anti-intellectualism 222 (35%)
Intellectualism 417 (65%)
Scores with additional
components Neutral tendencies 4%
Very anti-intellectual 1%
Anti-intellectual 30%
Very intellectual 3%
Intellectual 62%
Q1: Working on difficult
intellectual problems is Completely false 7 (1%)
enjoyable and stimulating Somewhat false 18 (3%)
for me. Neither true or false 42 (7%)
Somewhat true 319 (50%)
Completely true 253 (40%)
Mean 4.24
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Table 4 (continued).

Q2: I generally find physical

or recreational activities Completely false 36 (6%)
more satisfying than Somewhat false 181 (28%)
intellectual activities. (R) Neither true or false 215 (34%)
Somewhat true 151 (23%)
Completely true 56 (9%)
Means 2.98
Q3: I tend to feel somewhat
bored and impatient when Completely false 43 (7%)
dealing with remote, Somewhat false 215 (34%)
theoretical problems. (R) Neither true or false 130 (20%)
Somewhat true 205 (32%)
Completely true. 46 (7%)
Mean 3.01
Q4: Intellectual discovery is
ok, but I prefer other forms Completely false 44 (7%)
of excitement. (R) Somewhat false 246 (39%)
Neither true or false 170 (27%)
Somewhat true 147 (23%)
Completely true 31 (5%)
Mean 3.2
Q5: I’m probably the sort of
person who would find it Completely false 76 (12%)
thrilling to be engrossed in a Somewhat false 162 (25%)
research project. Neither true or false 81 (13%)
Somewhat true 223 (35%)
Completely true 97 (15%)
Mean 3.16
Q6: I deliberately seek out
sources of intellectual Completely false 8 (1%)
stimulation. Somewhat false 55 (9%)
Neither true or false 71 (11%)
Somewhat true 293 (46%)
Completely true 212 (33%)
Mean 4.01
Q7: I have more exciting
things to do than sit around Completely false 52 (8%)
and think all day long. (R) Somewhat false 194 (30%)
Neither true or false 182 (29%)
Somewhat true 171 (27%)
Completely true 40 (6%)
Mean 3.07
Q8: I feel compelled to
work on conceptual Completely false 49 (8%)
problems, even when I don’t Somewhat false 175 (27%)
have to. Neither true or false 139 (22%)
Somewhat true 225 (35%)
Completely true 50 (8%)
Mean 3.08

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Table 4 (continued).

Q9: One of my favorite

activities is discovering Completely false 70 (11%)
alternative ways to explain a Somewhat false 137 (21%)
particular phenomenon. Neither true or false 123 (19%)
Somewhat true 234 (37%)
Completely true 75 (12%)
Mean 3.17
Q10: The process of
examining a concept in Completely false 101 (16%)
great detail is generally Somewhat false 285 (45%)
unappealing to me. (R) Neither true or false 97 (15%)
Somewhat true 139 (22%)
Completely true 16 (3%)
Mean 3.50

Table 5

Cross tabulation of IAIS Categories and Demographic Variables

Age = N (%)

18 – 24 25 – 34 35 – 44 45 –54 55 –64 65-74

21 (49%) 118 (39%) 60 (32%) 15 (21%) 6 (22%) 2 (22%)

Anti-intellectualism
22 (51%) 184 (61%) 125 (68%) 57 (79%) 21 (78%) 7 (78%)
Intellectualism
Location by regions = N (%)
Southern Western Midwest Northeast Outside
US

Anti-intellectualism 114 (45%) 67 (45%) 46 (36%) 33 (36%) 0 (0%)

Intellectualism 138 (55%) 81 (55%) 83 (64%) 59 (64%) 1 (100%)
Licensure = N (%)

LPN RN APRN

Anti-intellectualism 17 (42%) 236 (43%) 21 (43%)

Intellectualism 23 (58%) 314 (57%) 28 (57%)
Highest degree level = N (%)
Cert. Diploma Associate Bachelor’s Master’s Doctorate

Anti-intellectualism
14 (40%) 0 45 (38%) 128 (35%) 28 (35%) 5 (19%)
Intellectualism
21 (60%) 4 (100%) 73 (62%) 242 (65%) 51 (65%) 22(81%)

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Table 5 (continued).

Political Party = N (%)

Republican Libertarian Green Democrat Indep None
Party

Anti-intellectualism 39 (60%) 5 (29%) 2 (100%) 120 (32%) 31 (33%) 27 (32%)

Intellectualism 26 (40%) 12 (71%) 0 255 (68%) 64 (67%) 58 (68%)

Primary source for health care trends = N (%)

Profess Employer Experts in the Govt Social

associations field agencies groups

Anti-intellectualism 59 (32%) 66 (48%) 16 (20%) 12 (46%) 28 (36%)

Intellectualism 124 (68%) 72 (52%) 64 (80%) 14 (54%) 50 (64%)
Primary source for health care trends (continued.) = N (%)

Other Social Media Professional peers Other Media

Anti-intellectualism 4 (17%) 28 (36%) 59 (32%) 17 (45%)

Intellectualism 19 (83%) 50 (64%) 124 (68%) 21 (55%)
Numbers are based on frequencies.

Correlational Data

A correlational analysis was conducted between the total IAIS score and the

demographic variables listed in Table 1 and Table 2. A Spearman’s Rho was used to

measure monotonic relationships between the total IAIS scores and the ordinal

demographic variables. Logistic regression was used to predict a binary independent

variable, from the total IAIS scores, and the demographic, and categorical variables.

Spearman’s Rho

A Spearman’s Rho correction analysis was used to determine a significant

relationship between demographic variables and the total IAIS score. Two variables were

found to have statistical significance – age a weak, positive correlation with a Spearman ꝩ

= 0.147 and significant of <0.001 on a two-tailed test, and level of religiousness, or

religiosity a weak, negative correlation at ꝩ = -0.177, p = 0.001. Therefore, as age

102
increases, the IAIS scores increase, indicating more intellectualism. As religiosity

increased, those who tend to be more religious had a decrease in IAIS scores. Both

variables have a weak correlation, as the further, away the Spearman’s coefficient is

away from 1, the weaker the relationship (Gray, et a., 2017). For this study’s objectives,

both independent variables have a correlation with the IAIS score, though weak, leading

to the rejection of the null hypothesis indicating no significant relationships between the

dependent and independent variables.

Logistic Regression

A logistic regression analysis was used to predict the probability, based on odds,

that practicing nurses would fall into the anti-intellectual category given demographic,

predictors, and variables (Gray et al., 2017). The analysis was performed between the

categorical demographic variables and the IAIS scores. The categorical demographic

variables used dummy variables for the analysis (Gray et al., 2017). The total IAIS score

was converted into a binary variable category, anti-intellectual and intellectual, from the

total IAIS scores. The target group was anti-intellectuals, and the reference group was

intellectuals. The goal of the logistic regression analysis was to determine predictors that

would correlate with the likelihood that the participant if randomly selected, would fall

into the anti-intellectual group.

Five independent variable groups were considered statistically significant. Those

groups were age, U.S. regional location, political party affiliations, additional non-

nursing degrees, and information obtainment for healthcare trends. Each model was

determined to have a goodness of fit by using the Omnibus and Hosmer and Lemeshow

test (Crowson, 2021; Osborn, 2015). The Omnibus test determines the likelihood ratios

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from a chi-squared test by comparing the null model to predictor models (Crowson, 2021;

Osborn, 2015). The variable models were determined to be statistically significant by the

Omnibus test (Crowson, 2021; Osborn, 2015). The Hosmer and Lemeshow also use chi-

squared testing, however with Hosmer and Lemeshow testing goodness of fit is

determined with higher p values (Crowson, 2021; Osborn, 2015). If the model does not

produce statistical significance from the Hosmer and Lemeshow, then the model is

considered a good fit (Crowson, 2021; Osborn, 2015). The Hosmer and Lemeshow

should be used with caution but is beneficial for testing analysis (Crowson, 2021;

Osborn, 2015). After each model was determined to have a goodness of fit, each

predictor variable (demographic data), was assessed for significance.

Age. The age variable was comprised of five age categories. Three of the five age

categories had a p-value < 0.05. The age categories of 35 – 44, 45 – 54, and 55 – 64 were

negative, significant predictors for anti-intellectualism; each age category had a

significant difference. The age variable was converted into dummy variables, and the

slope (β) for each category represents the difference between the categories in terms of

the odds of not score in the anti-intellectual range on the IAIS. Additionally, the three

significant age categories had an odds ratio of less than 1 indicating that anti-

intellectualism, or low IAIS, is less likely to occur as the predictor variable, age, is

compared to the 18 – 24 age group.

The age range of 35 – 44 had a regression rate of β = -.687, a p-value of 0.045,

and an odds ratio of 0.553 with a confidence interval of 0.257 to 0.985. The odds ratios

for the age category of 35 – 44 indicate that for every 1 unit increasing on this predictor

the odds of anti-intellectualism increase by 0.553. However, the age category has a

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negative correlation meaning that the odds of anti-intellectualism decrease. The age range

of 45 – 54 had a regression rate of β = -1.282, p = 0.003, and an odds ratio of 0.276

within the confidence interval of 0.121 to 0.629. The odds ratios for the age category of

45-54 indicate that for every 1 unit increasing on this predictor the odds of anti-

intellectualism increase by 0.276. The age range of 55 – 64 had a regression rate of β = -

1.206, p = 0.037, and an odds ratio of 0.299 within the confidence interval of 0.101 to

0.887. The odds ratios for the age category of 55 – 64 indicate that for every 1 unit

increase on this predictor the odds of anti-intellectualism increase by 0.299. As the age

range increased, the odds of falling into the anti-intellectual group decreased.

Location. The Midwestern regional location is a negative significant predictor of

the probability of anti-intellectualism. The regional location had a slope (β) of -0.609 and

an odds ratio of 1.839. For every 1-unit increment on the predictor, the odds of anti-

intellectualism increase by 1.839. For the location variable, the odds of anti-

intellectualism are decreasing, and practicing nurses from the Midwestern region are less

likely to be anti-intellectual than in other U.S. regions. See Table 6 for more statistical

information about predictor variables.

Non-Nursing Degrees. Those nursing participants who indicated that they had an

additional, non-nursing degree were less likely to score in the anti-intellectual range than

those who did not have additional degrees. The classification table indicates that

participants who had additional, non-nursing degrees were predicted to fall into the

intellectual category 100% of the time. The indication of non-nursing degrees had a

negative, significant correlation (β = -0.484, p = 0.006). However, the specific type of

non-nursing degrees did not test as significant. See Table 6 for more information.

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 Primary Source for Health Care Trends That Affect Practice. The sample group

of practicing nursing were asked to indicate their primary source of healthcare trends that

affect their nursing practice. The SPSS classification table indicated a 99.3% specificity

of the model for classifying health care information concerning the dependent variable.

Out of the nine options for health care trends, four options were statistically significant;

those options were professional associations, field experts, professional peers, and others.

The four options for health care trends were negatively significant with an odds ratio that

indicates a decrease in the probability of being anti-intellectual as the predictor variable

increases when compared to the other options. See Table 6 for additional information.

Political Party Affiliation. The political party affiliations had four party options

that were negatively significant. The negative coefficients suggest that the participants

who indicated libertarian, democrat, independent, or no party affiliations were less likely

to be anti-intellectual than when compared to other party affiliations, including the

republican and green parties. All four options for party affiliation had an odds ratio of

less than one, indicating a decrease in the probability of being anti-intellectual, as scores

on the predictor increase. The democratic, independent and no party affiliations had p

values of < 0.001. The overall classification total for party affiliations was 67.3% with

93% of cases correctly classified as intellectual and 17.6 % of cases correctly classified

as anti-intellectual. See Table 6 for more statistical information about predictor variables.

The logistic regression found significant correlations between five dependent

(predictor) variables and the independent variable. However, all five correlations were

negative. These negative correlations indicate the odds of being anti-intellectual are lower

than the odds of being intellectual. According to the analysis, the demographic variables,

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or intrinsic factors, could not determine a likelihood of anti-intellectualism among

practicing nurses over what would be expected by chance. Therefore, the null hypothesis

is not rejected. However, the logistic regression could determine the likelihood of

intellectualism among practicing nurses from the demographic variables.

Table 6

Single Item Logistic Regression Analysis (Predictive Items)

Variable Regression Significance Odds Ratio (Exp Odds Confidence

rates (β) (P-value) (B)) Intervals

Age:
35 – 44 -0.687 0.045 0.553 0.257 - 0.985
45 – 54 -1.282 0.003 0.276 0.121 - 0.629
55 – 64 -1.206 0.037 0.299 0.101 - 0.887

Location:
Midwestern
region -0.609 0.010 1.839 1.157 – 2.923

Additional non-nursing
degree:
Yes
-0.484 0.006 0.616 0.437 – 0.869

Source for health care

trends:

Professional
associations -0.656 0.005 0.519 0.329 – 0.819

Field Experts -1.299 <0.001 0.518 0.144 – 0.518

Professional peers -.0991 0.003 0.371 0.192 – 0.717

Other -1.471 0.011 0.230 0.074 – 0.710

Political party affiliation:

Libertarian
Democrat -1.281 0.030 0.278 0.087 – 0.882
Independent -1.159 <0.001 0.314 0.183 – 0.539
No Party -1.130 <0.001 0.323 0.168 – 0.622
-1.170 <0.001 0.310 0.158 – 0.609

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 Summary

Chapter IV reports the statistical findings from a quantitative data analysis based

on a descriptive, binate, and regression analysis. The data analysis was driven by the

purpose of this study and the presented research questions. The purpose was to

investigate the dependent variable, anti-intellectualism, and 25 independent variables

comprised of generalized demographic data and nursing-specific demographic data. The

research questions stipulated an analysis from a descriptive and correlational approach.

Chapter IV presented this study’s findings. Chapter V discusses the conclusions of those

findings.

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 CHAPTER V – CONCLUSION

Introduction

As the COVID-19 pandemic now transitions to an endemic, nurses have been the

subject of negative headlines. The negative press in circulation about nurses, typically,

pertains to controversial ideas regarding COVID-19, and the existence of anti-

intellectualism within the profession. Anti-intellectualism within the nursing profession

can negatively impact the prestige that the profession has worked for as well as cause

irreparable harm to those the profession serves. The recent negative attention to the

nursing profession, regarding anti-intellectualism, inspired this dissertation.

The literature review revealed that anti-intellectualism had not been empirically

investigated in a group of practicing nurses. Therefore, the overall purpose of this study

was to examine anti-intellectualism among a group of working nurses. This study had

three objects: (1) to determine if anti-intellectualism existed among a group of practicing

nursing and the depth in which it exists; (2) to determine if there were any significant

relationships between anti-intellectualism and demographic variables; and (3) determine

if the specific demographic variable would indicate a likelihood of anti-intellectualism.

Chapter V discusses the conclusions of this study’s findings regarding anti-

intellectualism among practicing nurses using quantitative methods. The discussion of

these findings is laid out questions. Additionally, Chapter V discusses the limitations and

the need for additional research in this area.

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 Discussion

RQ1: To what degree does anti-intellectualism exist in a group of practicing nurses?

A descriptive data analysis was utilized in determining the degree of anti-

intellectualism among a group of American practicing nurses. A group of practicing

nurses were asked to complete an intellectual-anti-intellectual scale (IAIS) – a series of

Likert scales that determined intellectual or anti-intellectual scores. The total scores from

the IAIS were calculated, and the participants were categorized as intellectual or anti-

intellectual. Higher IAIS scores fall within the intellectual range and lower scores fall

within the anti-intellectual range. The data analysis indicated that 222 of the nursing

participants scored low on the IAIS. Therefore, anti-intellectualism does exist within a

group of working nurses at a frequency of 35%.

The sample of working nurses, used for this dissertation, was comprised of three

types of nursing licensures. The three groups of nurses were LPN/LVNs, RNs, and

APRNs. For this study, the sample group had 8% of LPN respondents, 89% RN

respondents, and 6% of APRN respondents. In reference to Table 5, from Chapter IV,

anti-intellectualism was found in 42% of the LPN/LVN respondents, 43% of the RN

respondents, and 43% of the APRNs. The cross-tabulation revealed similar percentages

of anti-intellectualism among all three groups of nurses. The findings indicate that the

degree of anti-intellectualism does not vary between nursing licensure types. Further,

nursing educational levels had a similar frequency pattern.

The participants with practical nursing certifications scored in the anti-intellectual

range at 40%. Participants with bachelor’s degrees and master’s degrees in nursing

scored in the anti-intellectual range at 35%, and 38% of participants with associate

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degrees score in the anti-intellectual range. The percentages of anti-intellectual scores

among nursing certifications and associates, Bachelor’s and Master’s Degrees had little

variation. Those participants with doctorate degrees had fewer rates of anti-

intellectualism, at 20%, and participants with diplomas degrees did not score within the

anti-intellectual range. However, less than 1% of the nursing participants indicated they

had a diploma; given that such a small percentage of participants had diploma degrees,

this variable does not provide much of an impact on the findings. The consistency of anti-

intellectualism found between the practical certification and the associate, Bachelor's, and

Master’s Degrees was surprising and was not consistent with the empirical literature

regarding anti-intellectualism.

The literature that addresses anti-intellectualism among college students found

empirical evidence that those with higher educational levels are generally, less likely to

be anti-intellectual (Laverghetta et al., 2007; Laverghetta, 2015, Marques et al., 2017).

Laverghetta’s (2007, 2015) studies did use a different tool that measures anti-

intellectualism among students; however, the IAIS is a descendant of that tool. This study

hypothesized that educational levels made a difference in degrees of anti-intellectualism

based on the literature. However, this study proved otherwise.

In general, the expectation of higher education is to reduce anti-intellectualism,

but the findings indicate little difference in the frequency of anti-intellectualism across

degree levels. Further, the study results yielded little variation between nurses with

vocational training and those with academic training, which is a surprising finding

considering that academic training is widely thought to be superior. Additionally, the

findings resulted in the same frequencies of anti-intellectualism among those with

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undergraduate and graduate nursing degrees, except at the doctoral level. Participants

with doctoral degrees had a larger change in anti-intellectual levels when compared to the

other educational groups. The decrease in anti-intellectualism among those with doctorate

degrees appears logical, considering that doctoral degrees bear a significant resemblance

to more traditionally scholastic fields. Yet, nurses with an associated level of education

were found to have very similar degrees of anti-intellectualism to those with a master’s

degree education. The data suggest that the nursing educational level makes little

difference in the existence of anti-intellectualism, except at the doctoral level. The lack of

variation in the degrees of anti-intellectualism in education and licensure variables also

plays a role in the conclusions discussed further in Chapter V.

RQ2: Are there significant relationships between demographic variables that correlated

with anti-intellectualism among a group of practicing nurses?

A significant relationship was found between two demographic variables – age

and religiosity, and the IAIS scores. However, the relationship between both the

demographic variables and the IAIS scores are very weak. Nonetheless, the findings do

align with some of the results found in the literature review.

Marques et al. (2017) identified age as an indicator of anti-intellectualism.

Marques et al., (2017) specifically, stated that younger individuals are more likely to

experience anti-intellectualism. The finding for this study found a positive correlation

between age and IAIS scores, meaning that older participants were less anti-intellectual

than younger participants. The anti-intellectual trend in the age variable can also be seen

in Table 5. The cross-tabulations between age and IAIS scores show a decrease in the

frequency of anti-intellectualism as the age range increases. However, the percentage of

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anti-intellectualism becomes stagnant in the 55-64 (22%) and the 65-74 (22%) age

groups, though it is still within 1% of the previous age group (45-54). The stagnation is

likely due to the limited number of participants in those age groups; the 55-64 age group

was represented at 4% and the 65-74 age group at 1%.

Religiosity was the other demographic variable that was found to have a

relationship with anti-intellectual scores. Participants were asked to rank their level of

religiosity from not religious = 0 to very religious = 3 on a Likert scale. Participants also

had an option to select ‘do not know’, but those scores were not used in the correlation

analysis. The findings indicated a negative correlation with IAIS scores, ergo, as

religiosity increased higher degrees of anti-intellectualism were increased. The frequency

trends of the anti-intellectualism, in Table 5, present an increase in anti-intellectualism

frequency among those who are not religious (28%), to those who are slightly religious

(45%). The frequency trends of anti-intellectualism for moderately religious (44%) and

very religious (42%) are less frequent than those who are slightly religious (45%) but are

within proximity. The responses for not religious were 57% of the data collected and 8%

were very religious; the wide range of these numbers likely affected the trends in the

cross-tabulation and the strength of the correlation.

The findings, regarding religiosity, are also supported in Eigenberger and

Sealander’s (2001) anti-intellectual research and have a relationship with the concepts of

Hofstadter’s (1963) work. Eigenberger and Sealander’s (2001) work found positive

correlations between student anti-intellectualism and dogmatism in their empirical study.

Eigenberger and Sealander’s (2001), also, used a different measurement tool for anti-

intellectualism, however, the IAIS tool used in this research was modified from

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Eigenberger and Sealander’s (2001) SAIS tool (Marques et al., 2017). Additionally,

Hofstadter’s (1963) work addresses religion as one of the three contributing social

systems of anti-intellectualism. According to Hofstadter (1963) and Rigney (1991),

increased religiosity, or piety, can be a form of anti-intellectualism, called anti-

rationalism. Anti-rationalism is a form of and contributor to stronger anti-intellectual

tendencies. Hofstadter (1963) and Rigney (1991) support the idea that an increase in piety

can lead to an increase in anti-rationalism, therefore, anti-intellectualism. Hofstadter’s

(1963) work on anti-intellectualism served as the framework for this dissertation, and

though the correlation between anti-intellectualism and religiosity is weak, it is

significant in relation to the framework. The significance of the finding, itself, speaks to

the larger concepts of this dissertation, which is to say that the theoretical framework is

present in the empirical findings.

The lack of empirical findings also ties back to the theoretical framework.

Hofstadter (1963) believes that anti-intellectualism is a common problem within the

educational system. Hofstadter (1963) attributed the catalyzation of anti-intellectualism to

the democratization of intellect, via the educational systems. The democratization of

intellect has moved the educational system to a more universal, standardized system that

no longer combats anti-intellectualism through specialized intellectual cultivation

(Hofstadter, 1963). As addressed above, anti-intellectualism was found among a group of

practicing nurses who have completed some form of systematic nursing training or

education, and licensure process. Yet, the level of anti-intellectualism had little variation

between those with nursing certifications and those who completed college with nursing

degrees. Moreover, the data indicate that little to no variation was found between the

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different nursing degrees (Associate, Bachelor, or Master’s Degrees). In addition to the

frequency analysis, the education variable did not have any correlations with the IAIS

scores. The literature review suggests that nursing education’s practical approach to

learning, simply, effecting latent anti-intellectualism (Racine & Vandenberg, 2021). This

research’s findings support Racine and Vandenberg’s (2021) belief that nursing education

may be a contributor to anti-intellectualism among nurses.

RQ3: Which demographic data variables indicate a likelihood of anti-

intellectualism among practicing nurses

The research analysis did not find demographic data that indicated a likelihood of

anti-intellectualism among a group of practicing nurses. However, the analysis did find

demographic data that indicated a likelihood of not having anti-intellectual tendencies.

Out of the 25 different demographic variables, only 5 of the variables indicated

significant correlations with the independent variables. Those 5 variables were age,

location, additional non-nursing degrees, primary source for health care trends, and

political party affiliation. The statistically significant data findings, analyzed with logistic

regression, had negative correlations with anti-intellectualism. Essentially, the data

analysis revealed that certain demographic variables were indicators for scoring higher on

the IAIS scale, within the intellectual range. Since the focus of this dissertation pertains

to anti-intellectualism, and the analysis was based on an odds ratio, the correlation

finding is interpreted as a decreased likelihood of having anti-intellectual tendencies.

Age, again, was found to correlate with the IAIS scores. For the logistic

regression analysis, age was found to have a negative regression, indicating that the

higher age groups, when compared, were less liking to have anti-intellectual tendencies.

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The findings from the regression analysis support the findings from the bivariate analysis.

In addition, the relationships between age and anti-intellectualism were also supported in

the literature, as addressed under research questions two (RQ2) section of this chapter.

For these findings, age can be a predictor of higher anti-intellectual scores, and as a

participant increases in age, they are less likely to have anti-intellectual tendencies.

A surprising result was the correlation between U.S. location and the IAIS scores.

For the logistic regression analysis, participants from the Midwest were less likely to

have anti-intellectual tendencies when compared to other regions of the U. S. The odds

ratio (1.839) for the Midwest predictor is > 1, ergo the odds of not having anti-intellectual

tendencies are increasing. The literature review for this dissertation does not have

evidence to support this finding. An explanation of this correlation – IAIS scores and the

Midwest regional location, could not be justified after additional research.

The analysis of those participants who indicated an additional non-nursing degree,

from a yes/no indicator, found a correlation with the IAIS score. The finding indicated a

negative relationship with the target variable, anti-intellectualism. Therefore, those nurses

with an additional non-nursing degree are more likely to not have anti-intellectual

tendencies, than those who only have nursing degrees. For the participants with

additional non-nursing degrees, the degree types varied from associates to doctoral

degrees; see Table 3 for the complete list of additional non-nursing degrees. However,

the specific types of non-nursing degrees were not found to have significant correlations

with the IAIS scores, which is likely due to the wide variability of the non-nursing degree

type and the small percentage in data frequencies.

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 The easy explanation for the findings regarding additional non-nursing degrees is

that more years spent in the education system and an increase in an individual’s age are

presumed to lower anti-intellectualism. Those participants who have an additional non-

nursing degree are expected to be older, especially when considering the rise in

popularity of accelerated nursing programs. Accelerated nursing programs are fast-track

nursing degrees for those who already have a non-nursing degree. As discussed at the top

of this chapter, increased age correlated with increased ISIA scores, or less anti-

intellectualism, and was supported in the literature (Marques et al., 2017). The literature

also supports lower anti-intellectual levels with higher degree obtainment, as discussed

earlier in Chapter V (Laverghetta et al., 2007; Laverghetta, 2015, Marques et al., 2017).

However, Laverghetta and Nash (2010) found that more students who majored in more

practical degrees, like nursing, had more anti-intellectualism when compared to those

students with more theoretical degrees. Liberal arts and other science-based degrees

traditionally place more value on theoretical interpretation over practical skill

development and could explain the link between non-nursing degrees and IAIS scores.

However, the data from this study is limited for that comparison and the significant data

found conflicts with these ideas.

In accordance with this research’s findings, more time spent in a nursing (only)

educational system does not necessarily lower the frequency of anti-intellectualism,

except at the doctoral level. Further, the lack of significance for data regarding nursing

education data conflicts with the age correlations found. For example, an individual who

has a master’s degree in nursing is typically older than a person with a bachelor’s degree

in Nursing, yet anti-intellectual frequencies are the same. The conclusion between age

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and degree level is limited because it did not fall within the nature of this study, therefore

this idea is purely speculative. The data is perhaps better explained by a more viable issue

that the nature of nursing education is so steeped in a practical approach it does not affect

anti-intellectualism. Racine and Vandenberg (2021) suggest that nursing education’s

practicality is a link to nursing anti-intellectualism. From Hofstadter’s (1963) lens, the

findings would indicate that nursing education is generating anti-intellectualism.

One striking similarity between the findings and Hofstadter’s (1963) work is the

correlation between the IAIS scores and the primary source of healthcare trends that

affect practice. Hofstadter (1963) describes anti-intellectualism as the “resentment and

suspicion of the life of the mind, and those who are considered to represent it; and a

disposition to constantly minimize the value of that life” (p. 7). Therefore, those who

value intellectualism and the people who are intellectual representatives are considered

intellectual. The participants who chose the options: professional associations, field

experts, professional peers, and others as a source for health care trends were less likely

to have anti-intellectual tendencies than those who chose employers, coworkers, friends,

or family. See Table 4 for the complete list of options about health care trends. Further,

the variable of field experts had a significant of p = < 0.001. These results appear

axiomatic in that they empirically support Hofstadter’s (1963) concept of anti-

intellectualism. The findings pertaining to health care trends validate this study’s, overall,

purpose.

The correlation between political party affiliations and the total IAIS score was an

expected finding. The literature review and the framework of this study indicated a high

probability of anti-intellectualism association with political ideology. Eigenberger and

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Sealander (2001) and Laverghetta et al. (2007) found significant correlations between

anti-intellectualism with political and economic conservatism, and Hofstadter (1963) and

Rigney (1991) address the politics and powerful social system for anti-intellectualism.

The results of this study indicated that when comparing political party affiliations those

who have connections to the libertarian, democratic, independent party or indicated no

party were less likely to be anti-intellectual. Democratic, independent and no party

affiliations had p values of < 0.001, indicating a significant difference between the

groups, which includes the republican and green parties as well as the other variables

listed above.

As addressed in the former parts of this chapter, the data that did not result in

statistical significance is just as relevant as the data was significant. Something important

to note is the lack of significance regarding gender and nursing practice. The nursing

literature, discussed in Chapter II, addressed the domination of females within the

profession, and the culture of the female gender as potential factors for nursing anti-

intellectualism. The findings from this study’s analysis found no indication that gender

correlated with IAIS scores, which was also noted in Marques et al. (2017) study on anti-

intellectualism.

Nursing practice was addressed with approximately one-third of the questions on

the demographic questionnaire. The demographic questionnaire had over 10 questions

related to nursing practice, including employment and income. The content for these

questions was investigated for their relevance to the practical, or reflective

instrumentalization, component of anti-intellectualism. The data regarding employment

was not determined to be significant to this research. However, anti-intellectualism, in the

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form of practice, is mostly likely amalgamated into nursing education. Hofstadter (1963)

believes that educational systems are vectors for anti-intellectualism because they are

influenced by anti-rationalism, anti-elitism, and practicality. Nevertheless, the research,

regarding nursing, suggests that nursing education is the embodiment of practicality.

Consequently, the nursing education systems represent the source and spread of practical

anti-intellectualism.

Limitations

The study had some limitations due to the risk of sample bias. The sample was

overwhelmingly White (88%) and female (82%). However, the nursing profession

traditionally lacks diversity. Additionally, the sample size was primarily from the

millennial generation and had registered nurses (RN) licenses (89%) with BSN degrees.

On average, the American nurse is an RN with a BSN degree (a little over 50%) but

precedes the millennial generation in age (U.S. Bureau of Labor Statistics, 2019a). The

study had other potential biases due to the participant recruitment method. Participant

recruitment was done through multiple social media platforms. However, a large portion

of the respondents was from the social media site Reddit. Reddit is considered a more

liberal-leaning platform and the sample had a large majority of liberal-leaning

participants, at 62%. Further, the study’s findings revealed a significant correlation

between higher IAIS scores, the intellectual category, and political party affiliations.

The selected methods for analysis have a risk for potential limitations in the study.

Simply determining the frequency of anti-intellectualism among a group of nurses is

meaningful, but it does not provide a large amount of insight when anti-intellectual levels

are unknown to the general population or even other healthcare workers. A correlation

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analysis does not consider cause and effect, but only relationships (Gray et al., 2017).

Therefore, leaving room for inappropriate assumptions. Additionally, Spearman’s

correlation is less sensitive than another other bivariate correlational analyses, and a

logistic regression assumes that the independent variable and the dependent variables are

linearly related though they may not be (Gray et al., 2017).

In addition to limitations, the study has a delimitation. The study did not ask

participants about their COVID-19 vaccination status despite using COVID-19

vaccinations as an identified problem for this research. COVID-19 vaccinations have

become a controversial topic. Questions regarding COVID-19 vaccinations were

purposely omitted from the research questionnaire for fear of losing participation and

potentially causing conscious or unconscious, internal biases. Ultimately, this research’s

purpose was not to determine anti-intellectualism as it relates to vaccination rates.

Recommendations for Practice and Education

This study found anti-intellectualism among a group of working nurses. The

existence of anti-intellectualism can influence a nurse’s practice. However, the research

indicates anti-intellectualism is a possible product of nursing education, not nursing

practice. Therefore, the recommendation from this research focuses on nursing education

as it disseminates into nursing practice.

Anti-intellectualism had limited variation between licensure types and nursing

educational levels, except for doctoral degrees. The findings call for a change in nursing

education, specifically pre-licensure curriculums, for it is the gate into the profession.

The recommendation, based on the finding of this study, would be for nursing education

to take a step back from its heavily practical approach. Nursing education needs to have a

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better balance between teaching nurses how to critically think, write, and use philosophy,

as well as to perform a skill set, especially for degrees obtained within academia.

The answer is not to completely swing the pendulum away from a practical

education to a theoretical one. Making nursing theory more robust can potentially lead to

more anti-intellectualism. Academic rigor is shallow in nursing theory and meta

paradigms, which have their faults, and are not necessarily relevant to solving anti-

intellectualism as they are typically only available to a select few. Concepts like the

metaparadigm and epistemology are utterly foreign to the average nurse, no matter how

rigorously academia debates them. Only a select few nurses pursue academia and are

actively engaged with nursing theory. Therefore, efforts to curb anti-intellectualism

through the cultivation of nursing theory will, realistically, only tangibly affect those who

already engage at the top tears of nursing academia. Isolating focus on the cultivation of

nursing theory would likely entrench existing anti-elitist ideals, as addressed in the

literature review (Racine & Vandenberg, 2021). Indeed, this singular focus would lead

nursing theory to become more complicated and inaccessible to mainline nurses. In turn,

those who do not participate in the discussion are afforded a different path, which off-

handedly dismisses theory altogether, thus inviting even more anti-intellectualism in the

profession.

One potential solution is to require nurses to complete an additional degree or a

pre-nursing degree. The findings support a pre-nursing degree, in that those nurses who

had additional non-nursing degrees were found to be less anti-intellectual. However,

altering pre-licensure curriculums presents its own problem in that these changes run the

risk of metamorphizing the profession away from what it is. The nursing profession is

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good, and the educational system works, though anti-intellectualism remains a problem

that needs to be fixed.

Ultimately, completely “fixing” nursing education has its own potential problems;

however, the educational system should support and foster a value for intellectual

development and intellectuals, not neglect or even outright discourage it. This study

indicates that the entire nursing educational system needs a reassessment. We may not

have all the tools to fix anti-intellectualism within nursing education, because anti-

intellectualism must, fundamentally, be addressed on a societal level. However, the

nursing profession needs to have an open discussion about anti-intellectualism, and its

effects, to take a step forward in battling this problem.

Recommendations for Research

Simply put, more research is needed on anti-intellectualism, both from a nursing

and generalized perspective. Anti-intellectualism was found among a group of practicing

nurses, but how that compares to the general population is unknown, especially from an

empirical perspective. Additionally, this research needs to be replicated to have a more

diverse sample and to verify the validity and reliability of this study. Further, the findings

from this research suggest a gap in knowledge regarding the expression of anti-

intellectualism within nursing education. Anti-intellectualism within nursing education

needs further investigation, both theoretically and empirically.

Conclusion

Anti-intellectualism is the lack of value for intellectual pursuits and those who

pursue intellect. The anti-intellectual tendency is spread through the educational system

by the influence of anti-rationalism, anti-elitism, and practicality (Hofstadter, 1963;

123
Rigney, 1991). The outcomes of this study reinforce Hofstadter’s (1963) work regarding

anti-intellectualism, as the study found correlations to anti-rationalism, via religion, anti-

elitism, via political affiliations, and practicality through nursing education. The study

found anti-intellectualism exists among a group of working nurses. Nurses who have

anti-intellectual tendencies can limit the intellectual growth of the profession, as anti-

intellectualism is the adversary of intellectual development. The next step is to further

investigate anti-intellectualism and take measures to change it.

124
 APPENDIX A – Intellectualism-Anti-Intellectualism Scale (IAIS)

• Working on difficult intellectual problems is enjoyable and stimulating for me.

1 = completely false, 2 = somewhat false, 3 = neither true or false, 4 = somewhat

true, 5 = completely true

• I generally find physical or recreational activities more satisfying than intellectual

activities. (R)

1 = completely true, 2 = somewhat true, 3 = neither true or false, 4 = somewhat

false, 5 = completely false

• I tend to feel somewhat bored and impatient when dealing with remote,

theoretical problems. (R)

1 = completely true, 2 = somewhat true, 3 = neither true or false, 4 = somewhat

false, 5 = completely false

• Intellectual discovery is ok, but I prefer other forms of excitement. (R)

1 = completely true, 2 = somewhat true, 3 = neither true or false, 4 = somewhat

false, 5 = completely false

• I′m probably the sort of person who would find it thrilling to be engrossed in a

research project.

1 = completely false, 2 = somewhat false, 3 = neither true or false, 4 = somewhat

true, 5 = completely true

• I deliberately seek out sources of intellectual stimulation.

1 = completely false, 2 = somewhat false, 3 = neither true or false, 4 = somewhat

true, 5 = completely true

• I have more exciting things to do than sit around and think all day long. (R)

125
 1 = completely true, 2 = somewhat true, 3 = neither true or false, 4 = somewhat

false, 5 = completely false

• I feel compelled to work on conceptual problems, even when I don't have to.

1 = completely false, 2 = somewhat false, 3 = neither true or false, 4 = somewhat

true, 5 = completely true

• One of my favorite activities is discovering alternative ways of explaining a

particular phenomenon.

1 = completely false, 2 = somewhat false, 3 = neither true or false, 4 = somewhat

true, 5 = completely true

• The process of examining a concept in great detail is generally unappealing to me

(R)

1 = completely true, 2 = somewhat true, 3 = neither true nor false, 4 = somewhat

false, 5 = completely false (Marques et al., 2017).

126
 APPENDIX B – Demographic Questionnaire

• What is your age?

• 18-24
• 25-34
• 35-44
• 45-54
• 55-64
• 65-74

• What is your gender identity?

• Male
• Female
• Transgender
• Non-binary
• Other
• Prefer not to answer

• Are you of Hispanic, Latino, or Spanish origin? Yes/No

• How would you describe yourself (ethnicity)?

• White or Caucasian
• Black or African American
• American Indian or Alaskan Native
• Asian
• Native Hawaiian or pacific islander
• Multiple ethnicities

• What is your marital status?

• Single (never married)
• Married or in a domestic partnership
• Widowed
• Divorced
• Separated

• What is the number of people in your household?

• Please indicate the current (highest) nursing licensure you hold:

• PN/LPN/LVN
• RN
• APRN

• What is the highest degree or level of school you have completed?

127
 • Practical nursing certification
• Diploma in nursing science
• Associate Degree in Nursing
• Bachelor's Degree in Nursing
• Master's Degree in Nursing – nurse practitioner or nurse anesthesia
• Master's Degree in Nursing
• Doctor of Nursing Practice or Nurse Anesthesia
• Doctor of Philosophy in Nursing
• Doctor of Nursing Science

• Are you currently enrolled in school? Yes/No

• Do you plan to enroll in nursing school in the next 6 months? Yes/No

• What type of degree program are you enrolled in?

• RN to BSN
• MSN
• MSN – NP
• RN to MSN
• RN to DNP
• LPN to RN (Associates degrees)
• LPN to RN (bachelor’s degrees)
• DNP/DNAP
• PhD
• Post-master’s certification

• Do you have another degree? Yes/No

• Yes - please list the degree.

• What is your current employment status?

• Full-time employment (36 hours or more)
• Part-time employment (24 to 35 hours)
• PRN or Per diem (less than 24 hours)
• Retired
• Student
• Self-employed
• Homemaker
• Unemployed looking for work
• Unemployed not looking for work
• Unable to work

• Please list your nursing specialties and areas of practice.

128
• Do you have any nursing certifications? Yes/No
• If yes, please list.

• What is your primary source of information for keeping up with health care
trends, including trends that affect your practice?
• My employer
• Mainstream media, including tv, radio, and newspaper
• Social media
• Professional associations, like the American Nurses Association
• Governmental agencies
• My professional peers
• Friends, family, or other informal networks
• Experts in the field
• Other

• Do you have more than one job as a nurse? Yes/No

• Yes - How many and what is the employment status?

• Are you a travel nurse?

• Do you have insurance through your job?

• Was your personal income the last year you worked as a nurse influenced by
COVID-19-related rates or per diems? Yes/No

• What is your total household income (including you and your partner, if
applicable)?
• $10,000 to 19,999
• $20,000 to 29,999
• $30,000 to 39,999
• $40,000 to 49,999
• $50,000 to 59,999
• $60,000 to 69,999
• $70,000 to 79,999
• $80,000 to 89,999
• $90,000 to 99,999
• $100,000 to 149,999
• $150,000 or $ 199,999
• $ 200,000 or more

• Are you considering leaving the workforce? Yes/no

• Yes – Please explain.

129
• Have you recently left the workforce? Yes/No

• What U. S. state or territory do you currently live in (if no longer a resident of the
U.S., please indicate your current location)?
• Outside of the U. S. state, do you currently work in the U.S.? Yes/No

• Do you currently work in the same location where you live? Yes/No
• No-what U. S. state or territory do you currently work in?

• What type of community do you live in?

• Rural area
• Small city or town
• Large city
• Suburb near a large city

• Are you actively involved within your community? Yes/No

• If yes:
• Not involved
• Slightly involved
• Moderately involved
• Very involved

• To what level, do you consider yourself to be religious?

• Not religious
• Slightly religious
• Moderately religious
• Very religious
• Don’t know

• Select the political ideology you identify with the most:

• Conservative
• Moderate
• Liberal

• Are you registered to vote? Yes/No

• Did you vote in the last presidential election? Yes/No

• If registered to vote, what party are you affiliated with?

• Republican
• Libertarian
• Green party
• Constitutional party
• Democratic

130
 • Independent
• No party affiliation

• To what level, do you consider yourself to be religious?

• Not religious
• Slightly religious
• Moderately religious
• Very religious
• Don’t know

• What religious family do you belong to or identify yourself most close to?
• Asian Folk Religion
• Hindu
• Judaism
• Islam
• Christianity (Catholic, protestant, or any other Christian denominations)
• Other
• I am not religious (please specify)

• If Christian, what specific denominations do you practice?

• Baptist
• Pentecostal
• Methodist
• Evangelical
• Catholic
• Presbyterian
• Episcopalian
• Lutheran
• Anglican
• Non- denominations

131
APPENDIX C – IRB Approval Letter

132
 APPENDIX D – Recruitment Flyer

(Clip art of keyboard and stethoscope, n. d.)

133
 APPENDIX E – Modified Recruitment Flyer for Instagram and Twitter

(Vistacreate, 2022b)

134
 APPENDIX F – Additional Modified Recruitment Flyer for Facebook and LinkedIn

(Vistacreate, 2022a)

135
APPENDIX G – Image of Inclusion Criteria from Qualtrics Survey

136
APPENDIX H – Informed of True Research Intentions (Image from Qualtrics Survey)

137
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