C H A R A C T E R I S T I C S O F T H E N U R SI N G W O R K F O R C E

Exploring temperament and character traits in nurses and nursing students in a large regional area of Australia
Diann Eley, Rob Eley, Louise Young and Cath Rogers-Clark

Aims and objectives. To describe individual temperament and character trait proles associated with nurses and nursing students in a large regional health district and university in Australia. Background. Identication of personality characteristics have been undertaken in most professions; however there is little extant literature on nurses which looks at specic aspects of temperament and character. Design. A cross-sectional quantitative study of nurses and nursing students in a large regional health service district and university in South East Queensland, Australia. Method. An online survey to nurses and nursing students included a demographic questionnaire and the temperament and character inventory (TCI) to identify levels of the seven basic dimensions of temperament and character. Univariate analysis made multiple and covariate comparisons between TCI scores, nurses, students, working status and age. Results. The target number of responses was exceeded and totalled 451. Results are reported for females who comprised 90% of respondents; 535% students and 465% nurses. Signicant main effects for age and student status were detected in several temperament and character inventory dimensions. Working students had signicantly different temperament and character proles compared to non-working students. Conclusions. Overall, this sample displays levels of temperament and character traits congruent with a profession requiring high levels of persistence, self-directedness, cooperativeness and reward dependence. Our ndings prompt further investigation of whether individuals with the requisite temperament traits are attracted to nursing, or do individuals develop certain character traits as a product of their professional experiences/training. Relevance to clinical practice. The identication of distinct proles of temperament and character traits among different nursing roles may provide insight into what traits are conducive to retention of nurses in these roles. The predictive potential of the temperament traits plus the modiable component of character traits may provide scope for nursing educators and policymakers to assist in recruitment and retention of nurses in the workforce. Key words: character, nurses, nursing students, personality, temperament, workforce
Accepted for publication: 23 July 2009

Introduction
Traditionally, nursing is thought of as the caring profession. Persons who pursue nursing as a career have been stereotyped
Authors: Diann Eley, MSc, PhD, Director of Research, Rural Clinical School Research Centre, School of Medicine, The University of Queensland, Toowoomba; Rob Eley, MSc, PhD, Senior Research Fellow, Centre for Rural and Remote Area Health, The University of Southern Queensland, Toowoomba, QLD; Louise Young, MPsychED, PhD, Prevocational Training Manager, Australian College of Rural and Remote Medicine, Brisbane, QLD; Cath Rogers-Clark, PhD, RN, Professor of Nursing, Department of

as caring, serving and compassionate. The sparse literature around nurses and their personality traits focuses on the elements of their caring nature (Williams et al. 2009) and associated workforce problems in terms of burnout, stress,
Nursing and Midwifery, The University of Southern Queensland, Toowoomba, QLD, Australia Correspondence: Diann Eley, Director of Research, Rural Clinical School Research Centre, School of Medicine, The University of Queensland, Locked Bag 9009, Toowoomba, QLD 4350, Australia. Telephone: +61 (0)7 4631 5459. E-mail: d.eley@uq.edu.au

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coping and job dissatisfaction (Eastburg et al. 1994, Hegney et al. 2005). The shortage and maldistribution of nurses is worldwide (Buchan & Calman 2004). In Australia, recruitment and retention of nurses in rural, remote locations and areas of need is reported to be near crisis point (Kenny 2009). Most studies addressing this problem have been undertaken as purely workforce investigations to quantify turnover, expected retention and causes of intended departure. However, little is known about the fundamental traits that attract and retain people in the profession. This exploratory study serves as a starting point to establish a psychobiological prole for nurses. The specic objective of this study is to describe individual levels and combinations of temperament and character traits associated with nurses and nursing students in a large regional health district of Australia. The overall aim is to add to a greater understanding of the personality traits and the complex interplay of variables associated with individuals in the nursing profession. In time, this information may be the precursor to a new approach to address the maldistribution of nurses and the workforce issues that plague the profession through a greater awareness of the temperament and character traits intrinsic to nurses.

Background
Identication of personality traits have been undertaken in most professions (Borges & Savickas 2002). These personality studies type professionals using instruments such as the Big-Five Factor Model (McCrae et al. 2000) and the MyersBriggs Type Indicator (Stilwell et al. 2000). Findings have been used to direct career paths including those of medical and health science students and doctors in all specialities (Borges & Osmon 2001). However, personality and behaviour studies indicate there is no one type of person who chooses a profession or work in a particular location. Instead, there are idiosyncratic combinations of personality traits that predispose individuals to certain areas and interests in life (McCrae et al. 2000, Cloninger 2004). Two people working in the same job in the same location can have vastly different personalities. It is the combination of temperament traits that are mildly heritable and character traits that are inuenced by socio-cultural learning that contribute most strongly to our personalities and inuence our choices throughout life (Cloninger 2004). This study aims to describe a nurse population in terms of its specic personality traits of temperament and character. The investigation is not about labelling nurses as a type of
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person, but will build on previous research in doctors and medical students (Vaidya et al. 2004, Eley et al. 2008a,b, 2009) to identify the temperament and character proles that are most conducive to certain health professions and their practice locations. This study does not aim to nd an ideal nurse prole but to provide a better understanding of traits that might be associated with certain nursing roles. The theoretical framework for this work is based on an holistic view of personality and specically the withinperson constructs of personality development that underpins the main tool we employ, the temperament and character inventory (TCI) (Cloninger et al. 1993, Cloninger 1994). The TCI provides a psychobiological model of personality that has the potential to provide insight into human personality at multiple levels of analysis. The TCI is a set of tests designed to identify the relationships and the intensity of each of the seven basic personality dimensions of temperament and character that interact in ways to create the unique overall personality of an individual (Cloninger 2004). Temperament is dened as those components of personality that are heritable, developmentally stable, emotion based and not inuenced by socio-cultural learning. The four dimensions of temperament, all of which reect a heritable bias are as folows: 1 novelty seeking (NS) observed as exploratory activity in response to novelty, impulsiveness and extravagance; 2 harm avoidance (HA) observed as pessimistic worry in anticipation of problems, fear of uncertainty, shyness with strangers and rapid fatigability; 3 reward dependence (RD) indicates cues of social reward and is observed as sentimentality, social sensitivity, attachment and dependence on approval by others; 4 persistence (PS) describes behaviour despite frustration, fatigue and reinforcement. It is observed as industriousness, determination and perfectionism. Character traits reect personal goals and values and are subject to socio-cultural learning. Each trait quanties the extent to which an individual displays certain related qualities: 1 self-directedness (SD) responsible, reliable, resourceful, goal-oriented and self-condent; 2 cooperativeness (CO) cooperative, tolerant, empathic and principled; 3 self-transcendence (ST) self-perception in relation to the universe as a whole and observed as spirituality, practicality, materialism and modesty. The identication of distinct proles of temperament and character traits among different nursing roles may be the precursor to a better understanding of the traits conducive to

2010 Blackwell Publishing Ltd, Journal of Clinical Nursing, 20, 563570

Characteristics of the nursing workforce

Temperament character nurses, nursing students

successful long-term retention of nurses in these roles and specic workplace locations. The predictive potential of temperament traits plus the modiable component of character traits may offer opportunities for nursing educators and policy-makers to better understand the traits associated with certain nursing roles. In time, this information may assist in recruitment and retention of nurses in the workforce and to nursing students in making career pathway decisions.

Table 1. Raw TCI data were scored externally by Washington University, St Louis, USA. Returned individual participant dimension scores and demographic data were entered into SPSS version 14 (SPSS Inc, Chicago, IL USA) for analysis. The internal consistency (Cronbach alpha) of the dimensions in our sample ranged from 086089 for character and from 071091 for temperament scales.

Analysis
Descriptive statistics summarised the data. All analyses used a = 005 with an accompanying 95% condence level for measuring signicant differences between variables. Univariate analysis (ANOVA and two-way ANOVA ) were used for multiple and covariate comparisons between TCI scores among nurses, students, working status and age.

Methods
Design
The study employed a quantitative cross-sectional design. Ethical approval was obtained from the Behavioural and Social Science Ethical Review Committee of the University of Queensland and the Human Research Ethics Committee of the University of Southern Queensland.

Results
In designing the study, we were aware that it would not be possible to ascertain the exact number receiving the initial email invitation to participate because the survey had to be distributed by third parties via an email link. The intent of the study was to have enough subjects to make comparisons among students and nurses for a power of 080 at alpha 005. Estimations showed that 400 responses would provide statistical signicance. We received 451 useable responses and the resultant analysis conrmed an observed power >099, which exceeded our estimation. As suspected, the number of male responses was consistent with their proportion in the workforce. Women comprised 404 or 90% of the respondents. In the student sample (n = 237; 5346%), there were 216 (911%) females. Preliminary analysis showed that three TCI subscales (our dependent variables) were signicantly different between male and females at p < 0001. These ndings are consistent with those reported in the literature on sex and temperament and character trait levels (Cloninger et al. 1993, Vaidya et al. 2004). Because of this and the fact that males represented only 10% of our sample, this article will only report the female data.

Data collection
Setting The setting was a regional health service district and university in South East Queensland, Australia. Participants Participants were nurses employed in public and private health services and nursing students enrolled in their last year of a pre-registration Bachelor of Nursing degree. A signicant number of students were also employed in the same public and private health services and in aged care. The health department and the university nursing department provided email access to potential participants who received an invitation to participate, an information sheet and immediate access to the online survey instruments. Materials The online instruments were a demographic survey [two three minutes] and the TCI-R 140 (Cloninger 1994) [20 minutes]. The former included questions on age, sex, nurse title, main nursing job, education and work status, length of time as a nurse, workplace location, anticipated time in nursing and rural/urban background. This article reports only on the TCI results by age and nurse or student status. Data collection occurred between AugustNovember 2008. The TCI-R 140 is the ve point Likert scale version of the self-report questionnaire designed to assess three character and four temperament dimensions of personality described in

Demographics
Table 2 displays our sample in detail by age and stratied by student working status. Employment All nurses were currently employed with 87% (n = 187) working as registered nurses. Almost half of the nursing
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D Eley et al. Table 1 Temperament and character descriptors High scorers Temperament HAHarm avoidance Low scorers

NSNovelty seeking

RDReward dependence

PSPersistence

Worrying and pessimistics Fearful and doubtful Shy, fatigable Exploratory and curious Impulsive, disorderly Extravagant and enthusiastic Sentimental and warm Dedicated and attached Dependent Industrious and diligent Hard-working Ambitious and overachiever Perseverant and perfectionist Mature and strong Responsible and reliable Purposeful, self-accepted Resourceful and effective Habits congruent with long-term goals Socially tolerant Empathic, helpful Compassionate and constructive Ethical and principled Patient Creative and self-forgetful United with universe

Relaxed and optimistic Bold and condent Outgoing, vigorous Indifferent, reective Frugal and detached Orderly and regimented Practical and cold Withdrawn and detached Independent Inactive and indolent Gives up easily Modest and underachiever Quitting and pragmatist Immature and fragile Blaming and unreliable Purposeless, self-striving Inert and ineffective Habits congruent with short-term goals Socially intolerant Critical, unhelpful Revengeful and destructive Opportunistic Impatient Pride and lack of humility Scientic/objective

Character SDSelf-directedness

COCooperativeness

STSelf-transcendence

Adapted from Cloninger et al. (1993).

Table 2 Age of sample and students stratied by working status Non-working students % 536 153 417 171 194 65 n 114 21 54 19 16 4 0 % 53 183 470 165 148 35 Working students n 102 12 36 18 26 10 0 % 47 118 353 176 255 98

Total n Age total Under 20 years 2029 years 3039 years 4049 years 5059 years 60 years+ 404 33 103 66 114 77 11 % 82 255 163 282 191 27

Nurses* n 187 0 13 29 71 63 11 % 464 70 155 380 337 59

Students n 216 33 90 37 42 14 0

*All nurses reported as currently employed in nursing.

students (n = 101, 467%) were working as an assistant in nursing (AIN) or enrolled nurse while also studying. Age Overall and in the nurse cohort, the 4049-year age group was largest in number. The smallest group was over 60. Among students, 82% were 2029 years old although 353% of the working students were between 4049 years of age.
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Differences in TCI TCI scores were normally distributed (Kolmogorov Smirnov statistic, Normal Q-Q Plots). Comparison of our samples overall TCI scores with Cloningers (1994) population norms, showed scores for NS in the high percentile, RD, PS, SD and CO in the very high percentile and HA and ST average (see Table 3 for percentile value ranges).

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Characteristics of the nursing workforce SD, standard deviation. *Sample mean scores ranked against published population norms. Ranking percentiles: VL, very low = 0167%; L, low = 1733%; AV, average = 34667%; H, high = 67833%; VH, very high = 84100%. Taken from Cloninger et al. (1994). Signicant at p < 005 level. Signicant at p < 0001 level. 1020 965 1015 913

Temperament character nurses, nursing students

ST Selftranscendence

992

SD

Univariate comparison of TCI scores

Comparisons by age Respondents under 40 years of age were higher in NS than those over 40 years [F(5, 398) = 3199, p < 0008]. Compared to all other age groups, the 3039 year olds were highest in PS [F(5, 398) = 2811, p < 0014] and the under 20 years was lowest in SD [F(5, 398) = 2351, p < 0040] and CO [F(5, 398) = 2637, p < 0023]. Comparison by student/nurse status Students were higher in NS, [F(1, 401) = 4133, p < 0043], RD [F(5, 398) = 9548, p < 0002] and PS [F(5, 398) = 20157, p < 0001] compared with nurses.

comparisons between nurses and students and working and non-working students

4777 Average

Mean

4698 4848 699 809 995 1063 8041 7946

760

CO Cooperativeness

7992 Very high

1031

SD Selfdirectedness

7514 Very high

991 1091

SD

8074 7842

Mean

784 819

SD

4940 4759

7724 7304

Mean

7528 7496

Two-way

ANOVA

comparison of TCI scores

Table 3 Temperament and character inventory scores for the total sample and two-way

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Total sample *Normative comparison Two-way ANOVA covaried All nurses All students Two-way ANOVA covaried Working students Non-working students

Because differences in age and student/nurse status are confounded, two-way ANOVA are most appropriate to interpret. Two-way between groups ANOVA with post hoc comparisons (Tukeys HSD) were conducted to covary for the signicant effects of age and student/nurse status and explore the impact of student, nurse and working history on each TCI dimension. There were no signicant interaction effects detected for any of these variables or for rural background. Signicant main effects were conrmed for age in NS: [F(5, 393) = 2344, p < 0041], partial g2 = 0029, SD: [F(5, 393) = 2828, p < 0016], partial g2 = 0035 and PS: [F(1, 393) = 16685, p > 0000], partial g2 = 0041, for student in RD: [F (1, 393) = 4663, p < 0031], partial g2 = 0012 and PS: [F (1, 393) = 16685, p < 0000], partial g2 = 0041 and for working student were lower in HA: [F(1, 215) = 16112, p < 0000], partial g2 = 009 but higher in SD [F(1215) = 8686, p < 0004], partial g2 = 0008 and CO [F(1215) = 4501, p < 0035], partial g2 = 0006 than non-working students (Table 3). A summary our analysis that covaried by age or student/ nurse status follows: 1 comparisons of the whole sample by age showed that younger students and nurses are higher in NS than older students and nurses, all students of any age were higher in RD than nurses and younger nurses are lower in PS compared to older nurses and all students. 2 comparisons among students showed that working students are lower in HA and higher in CO than non-working students and older students and those students who are working are higher in SD than younger or non-working students.

PS Persistence

7327 Very high

938

7103 7513 883 856 6986 7254 1024 1179 720 736 5438 5586 5429 5411

Mean

828 983

ANOVA

RD Reward dependence

7130 Very high

Mean

877

HA Harm avoidance

5418 Average

1108

NS Novelty seeking

Mean

404 for age 187 216 for age 102 115

5516 High

5530 5630

741 731

731

SD

5078 5700

Mean

1048 1212

SD

7337 7183

814 885

SD

7565 7480

915 1045

SD

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D Eley et al.

Discussion
This exploratory study has described the levels of temperament and character traits in a sample of female nurses and nursing students from a large regional health district and university in Queensland. This is the rst investigation of this kind in the nursing profession and is unique because unlike previous personality research, it specically identies levels of temperament and character traits the two most important components of personality (Cloninger 2004). The study lays the foundation for more comparative work that will describe proles of temperament and character traits associated with different nursing roles and practice locations and may help explain how these traits inuence nurses choice of professional roles and decisions to stay in a particular work context. Findings could be important in devising sophisticated approaches to workforce issues around recruitment and retention. This new approach makes direct comparisons with other personality ndings in nursing difcult for two reasons. First, most of the personality literature pertaining to nurses is limited to elements of its caring nature (Williams et al. 2009) and personal problems of the profession in terms of burnout, stress, coping and job dissatisfaction (Eastburg et al. 1994, Hegney et al. 2005). Second, the TCI was developed through consideration of social and biological determinants of individual differences (Cloninger 2004), and therefore it is difcult to compare this, the rst study with nurses, with personality inventories based on the personality assessment literature. Nevertheless, studies comparing the TCI with the Five Factor Model do show common characteristics with which all TCI scales correlate highly and show considerable overlap (De Fruyt et al. 2000). The modest sample size from one state in Australia is a recognised limitation and the prevalent bias around the selfselected nature of participation and non-responders is noted, in particular, because one of the character traits measured is CO. There was no difference between early and late responders but it is only assumption that the same is true for the responders and non-responders. A further caveat is that this is a cross-sectional study measuring variables at one point in time and we cannot assume that the characteristics of our sample were constant. The demographics of our sample reect the ageing nursing workforce (Australian Institute of Health and Welfare 2008). This was also evident in the student cohort (43% over 30 years old) and may imply a large proportion of these students are current nurses up-skilling current qualications or changing careers as well as entering the workforce.
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Our sample of nurses, compared with Cloningers published population norms display temperament and character traits congruent with a profession requiring higher than normal levels of PS, SD, CO and RD. Our ndings are also consistent with the limited available literature on temperament and character regarding age and sex differences in the general population (Cloninger 2004, Vaidya et al. 2004). This age effect was evident and required analyses to covary for age and student status. The signicant differences because of sex despite the small number of male respondents, justied the analysis of only the female cohort at this time. Further work includes a similar investigation on a larger sample of males.

Comparison of TCI trait levels

Age Age differences in TCI traits concur with both our previous work (Eley et al. 2009) and the literature (Kluger et al. 1999, Vaidya et al. 2004) that conrm younger age groups are highest in NS but lowest in SD and CO. This suggests that younger age groups regardless of nurse/student status are not only more open, curious, impulsive and enthusiastic (i.e. high NS), but also more unreliable and ineffective, with habits congruent with short-term goals (low SD: i.e. unsure of what they want). Low CO suggests someone who is less tolerant, less helpful and more opportunistic than average another reection of immaturity. Our ndings also detected the middle-aged group, who were the largest in number, scored highest in PS compared to all other ages. This age may be considered mid-career and suggests that at this stage, nurses are maintaining a high level of motivation and diligence to their profession. Nurses vs. students Student nurses are higher in NS, RD and PS compared to nurses in our sample. These differences were mainly because of the general age difference, and analyses conrmed a main effect for age in NS and PS. This implies that student nurses who make up the younger age groups are more open to trying new things (high NS) and are more persistent and industrious (high PS) than professional nurses. However, ignoring this age effect also portrays student nurses as more dependent on social networks, contacts and friends (high RD) and may reect the more social nature of student life. An important consideration in our analysis is that approximately half of the student participants were already working as a nurse, almost exclusively as AINs. This justied investigation of differences between working and nonworking students. A particularly interesting nding was that

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Characteristics of the nursing workforce

Temperament character nurses, nursing students

these working students had very different temperament and character proles to non-working students, which were detected even after adjusting for age. Non-working students were lower in the character traits of SD and CO and higher in HA than working students. Low SD shows someone who tends to be blaming and is less reliable and less able to dene, set and pursue internal goals. Low CO is indicative of someone who tends to be self-absorbed, less tolerant, more opportunistic and looks out for themselves. Additionally, the levels of HA in non-working students were not only higher than working students but ranked higher than the population norms. HA is a temperament trait that is highly indicative of the ability to cope in uncertain and difcult situations. Persons high in HA tend to be fearful, shy, passive and lack condence in uncertain situations. These ndings warrant further investigation to determine whether students of other professions, who do not also work in that profession, have similar temperament and character trait proles. The levels of character traits (i.e. modiable) suggest that student nurses already working in their profession as an AIN have either developed greater SD and CO through their nursing experience or these traits attract them to working in the profession while studying. If the lower level of the temperament trait (i.e. innate) HA (more condent and able to cope with uncertainty) is added to the working students prole, it completes a picture of a more mature and adjusted personality. As students in our sample generally tend to be younger, these ndings may suggest that engaging in paid nursing work help them develop positive character traits (condence, goal oriented, cooperative) that may in turn assist them in their studies and later employment as registered nurses. Again, further investigation might help determine which traits are more dominant in inuencing the decisions associated with this pattern of traits.

RD), hard-working, perseverant and ambitious (very high PS), very realistic, resourceful and effective (very high SD) and tolerant, supportive and good team players (very high CO). Further work will focus on investigating the proles of rural and remote vs. urban nurses to help identify and perhaps predict the temperament and character traits most suited to certain workplace locations. Further work is underway that explores temperament and character traits and other variables such as work history, i.e. length of time as a nurse, job title, workplace location history and workplace intention and rural/urban background to further explore factors that may be associated with personality traits and nursing roles.

Relevance to clinical practice

A myriad of demographic, developmental and environmental factors inuence an individuals life choices and psychological prole. Nevertheless, the utility of understanding the temperament and character trait proles of individuals and groups is that temperament traits, being stable, may be predictive of individuals with similar temperament proles. For example, identication of the temperament proles of long-term successful nurses in various roles and practice locations may be indicative (predictive) of the traits conducive to coping in those roles and locations. On the other hand, the developmental nature of character traits would highlight areas of modication or development, through training and education. Both are of probable value to nursing educators, recruiters and policy-makers intent on greater retention of the nursing workforce. The perennial question is whether individuals with the requisite and, according to our study, observed temperament trait levels are attracted to the nursing profession or is it more the case that individuals develop (increase or decrease) certain character traits as a product of their experience and training. This is an area of further investigation and debate in many professions but at the very least may provide a greater understanding of the individuals working in those professions.

Conclusions
Ultimately, when it comes to recruitment and retention of the workforce in any profession, the goal is to make that profession attractive to all personality types. The TCI does not classify or label personality types. Instead, it identies trait proles that are more or less successful in various life situations, professions or locations. Our sample of nurses in general is indicative of individuals who are balanced in their ability to cope with uncertain situations (average HA) and in their conception of themselves as part of the community (professional and social) they live in (average ST). They are modest risk takers and slightly impulsive (high NS). Additionally, they are highly sensitive and sociable (very high

Acknowledgements
This study was made possible by a grant from the University of Southern Queensland, Faculty of Sciences.

Contributions
Study design: DE, RE, CR-C; data collection and analysis: DE and manuscript preparation: DE, RE, CR-C.
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Conict of interest
The authors declare no conict of interest.

References
Australian Institute of Health and Welfare (2008) Nursing and Midwifery Labour Force. National Health Labour Force Series No. 39. AIHW, Canberra. Borges NJ & Osmon WR (2001) Personality and medical specialty choice: technique orientation versus people orientation. Journal of Vocational Behavior 58, 2235. Borges NJ & Savickas ML (2002) Personality and medical specialty choice: a literature review and integration. Journal of Career Assessment 10, 362380. Buchan J & Calman L (2004) The Global Shortage of Registered Nurses: An Overview of Issues and Actions. International Council of Nurses, Geneva. Cloninger CR (2004) Feeling Good: The Science of Well Being. Oxford University Press, New York. Cloninger CR, Przybeck TR, Svrakic DM & Wetzel RD (1994) The Temperament and Character Inventory (TCI): A Guide to its Development and Use. Center for Psychobiology of Personality, St Louis, MO. Cloninger R (1994) Temperament and personality. Current Opinion in Neurobiology 4, 266273. Cloninger R, Svrakic DM & Pryzbeck TR (1993) A psychobiological model of temperament and character. Archives of General Psychiatry 50, 975990. De Fruyt F, Van De Wiele L & Van Heeringen C (2000) Cloningers psychological model of temperament and character and the fivefactor model of personality. Personality and Individual Differences 29, 441452. Eastburg M, Williamson M, Gorsuch R & Ridley C (1994) Social support, personality and burnout in nurses. Journal of Applied Social Psychology 24, 12331250.

Eley D, Young L & Prysbeck T (2008a) Exploring temperament and character in medical students; a new approach to selection and training to increase the rural workforce. Medical Teacher iFirst, 16. Eley D, Young L & Shrapnel M (2008b) Rural temperament and character: a new perspective on recruitment and retention of rural doctors. Australian Journal of Rural Health 16, 1222. Eley D, Young L & Prysbeck T (2009) Exploring the temperament and character traits of rural and urban doctors; implications for retention of the rural workforce. Journal of Rural Health 25, 4349. Hegney D, Plank A & Parker V (2005) Extrinsic and intrinsic work values: their impact on job satisfaction in nursing. Journal of Nursing Management 13, 111. Kenny A (2009) Nursing Shortages will Cripple Rural Health Care. Available at: http://www.abc.net.au/news/stories/2009/02/02/ 2479976.htm (accessed 2 February 2009). Kluger M, Laidlaw T, Kruger N & Harrison M (1999) Personlity traits of anaesthetists and physicians: an evaluation using the Cloninger Temperament and Character Inventory (TCI-125). Anaesthetisia 54, 926935. McCrae RR, Ostendorf F, Angleitner A, Hrebickova M, Avia MD, Sanz J, Sanchez-Bernardos ML, Kusdil ME, Woodfield R & Saunders PR (2000) Nature over nurture: temperament, personality and life span development. Journal of Personality and Social Psychology 78, 173186. Stilwell NA, Wallick MM, Thal SE & Burlseon JA (2000) MyersBriggs type and medical specialty choice: a new look at an old question. Teaching and Learning in Medicine 12, 1420. Vaidya NA, Sierles FS, Raida MD, Fakhoury FJ, Przybedk TR & Cloninger R (2004) Relationship between specialty choice and medical student temperament and character assessed with Cloninger Inventory. Teaching and Learning in Medicine 16, 150156. Williams G, Dean P & Williams E (2009) Do nurses really care? Confirming the stereotype with a case control study. British Journal of Nursing 18, 162165.

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